Medicaid buy-in proposal would raise payment rates to match Medicare

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U.S. Sen. Brian Schatz, D-Hawaii, is preparing to introduce legislation to allow Affordable Care Act (ACA) exchange customers to buy into Medicaid, offering a government-run “public option” similar to ones discussed but ultimately left out of the law.

In an interview with Vox, Schatz said if states take up the option, customers who qualify for ACA subsidies would be able to use them to buy into Medicaid. It would also raise Medicaid reimbursements for physicians and hospital to match that of Medicare to keep providers from turning away Medicaid patients, which he acknowledged would make the public option and Medicaid itself more expensive.

“You pay providers more; that doesn’t come from thin air,” Schatz said. “My judgment is you’re going to get better uptake if you have a broader provider network, and the more participants, the better the risk pool and the better the score.”

Democrats, like Republicans, have their own intraparty battles over healthcare policy, with 60 percent of the party’s members in the House signing onto a bill to introduce a single-payer system in the U.S. Schatz said he’s in favor of single-payer even as he crafts a different proposal which may not achieve universal coverage.

“If there’s ever a vote for single-payer, I’m a ‘yes,’” he told Vox. “But there are lots of things we can do in the meantime to make progress for tens of millions of Americans. And we should do those things.”

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