Medicaid Buy-In

There's been a lot of buzz recently about the possibility of Medicaid buy-in—allowing New Mexicans who are not currently eligible for Medicaid to buy into this public insurance program.

Medicaid, as you probably know, is a federal program, administered by the states, that provides health care coverage to lower-income Americans. Under the Affordable Care Act, Medicaid was expanded to include those earning up to 138% of the federally designated poverty level (this amounts to $34,638 for a family of 4). Medicare, in contrast, is a federal program that provides health care coverage to older Americans, beginning at age 65.

Why are people talking about Medicaid buy-in, and what is it? While the number of uninsured New Mexico residents has dropped dramatically since passage of the Affordable Care Act, there are still an estimated 180,000 people without health care coverage in our state. Allowing people to pay into the Medicaid system to gain access to good health coverage would help close that gap. (People would pay a premium, as they do with private insurance, to buy into Medicaid.) 

In 2018, the NM legislature passed a memorial (a "formal expression of legislative desire" that doesn't have the force of law) in favor of studying the feasibility of this proposal. A study would look at affordability, eligibility, benefit package, impact on medical providers (Medicaid reimbursement rates are generally low), and possibilities for federal funding. Clearly, the cost of such a program is critical to its feasibility. 

Our take on Medicaid buy-in: In 2019, there is a great probability that the Health Security Act will pass and become law. (Democratic gubernatorial candidate Michelle Lujan Grisham has publicly come out in support of the bill, and the fall elections will hopefully bring in even more pro-Health Security legislators.) But it will take time (approximately three years) for the Health Security Plan to be up and running. Setting up our own homegrown health plan needs to be done carefully, with lots of public input. 

In the meantime, it's important for as many New Mexicans as possible to have health coverage. Therefore, we don't see a conflict between this interim solution and the Health Security Plan. 

What we're working for with the Health Security Act is a systemic solution to the problems we face due to our complex, out-of-control private health insurance system.