Some states aren't waiting for a Medicare for All action by the federal government. Instead, they're looking at ways for the uninsured to buy in to Medicaid by paying premiums—something that Medicaid recipients don't do in most states.

According to Stateline, at least 10 states are considering such action, and even though plans offered under such a program might not offer all the benefits traditional beneficiaries have access to, the plan's supporters say the policies could appeal to people who can't manage the cost of plans on health care exchanges. In addition, they could trigger competition that could lower prices for everybody.

Of course it's not likely that any such action could make it out of the nation's capital, considering the current standoff climate, but states aren't hanging around waiting to see if miracles happen. Instead they're taking action on their own.

“We think 2019 is going to be the year of Medicaid buy-in,” Allison O'Toole, senior director of state affairs for United States of Care, a nonpartisan group that promotes affordable health care for all, told Statline, pointing out the traditional notion that states, not the federal government, are the “laboratories of democracy” where innovative solutions most often arise.

Nevada actually passed a buy-in program in 2017, but its then-governor, Republican Brian Sandoval, vetoed it. Now, however, a Democrat rules in the state capital, and legislators plan to file a new bill and are optimistic about its chances this time around.

Last year New Mexico ordered a study of how such a program might work, and with its new Democratic governor, as well as Democratic majorities in both houses, the state also holds out hope for a bill in the planning stages.

Studies of buy-in options are also underway in California, Delaware, Oregon and Washington, while the new governors of Connecticut, Illinois, Minnesota and Wisconsin support such a program. In addition, Statline cites a pre-midterm poll commissioned by MPR News and the Minneapolis Star Tribune that indicated 70 percent of likely voters would support allowing people to buy into a public option such as Medicaid or Medicare.

Even more support such an option nationally, with 78 percent of registered voters saying their elected officials ought to put it on their priority list.

Of course it's not universally approved, with opposition from Republican lawmakers as well as from the insurance industry, but it remains to be seen whether in the current climate such opposition will stand against what may be a turning tide.

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Forget Medicare for All; more states eye Medicaid buy-in

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