New York Magazine reported on a proposal to allow people to pay for Medicaid instead of requiring them to purchase insurance coverage on the insurance market.

Allowing states to offer Medicaid as a public option would certainly make health care more affordable for those buying insurance on the individual market. It would also help control health-care costs, since the program’s reimbursement rates would be lower than those of a typical insurance provider.

As Vox reports:

Schatz’s bill would give all states the option of opening up their Medicaid programs to uninsured Americans who wish to purchase coverage. It would be similar, functionally, to how states currently have the option under Obamacare to expand their program to all Americans making less than 133 percent of the federal poverty line (about $15,000 for an individual).

It would preserve Medicaid as is for the low-income Americans who already are enrolled on the program. But it would let those who are currently too high-income to qualify pay a premium to join the program. Those who qualify for Affordable Care Act tax credits would be able to use the subsidies to buy into the Medicaid program, just as they do right now to buy private coverage on the marketplace. That would make Medicaid into the Affordable Care Act’s public option, creating another insurance plan in markets with few or no private plans and putting private payers in competition with the much cheaper Medicaid system.

Incredibly, Medicaid buy-in would achieve all this without requiring tax increases; throwing anyone off their employer-provided plans; or, even, negatively altering the health-care systems in any way.

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