The Effects of Medicare Buy-In Policies for Older Adults on Health Insurance Coverage and Health Care Spending

A Medicare buy-in program would allow qualifying individuals currently ineligible for Medicare to purchase a Medicare-like health insurance plan. The buy-in would be administered as a distinct program but could take advantage of Medicare’s premium structure, benefit design, or provider payment rates (NASI 2020). After comprehensive health reform failed to materialize during the Clinton administration, Medicare buy-in policies gained prominence as potential incremental reforms (Johnson, Moon, and Davidoff 2002).1 Given the popularity of the Medicare program, borrowing elements from the existing program may be an appealing way to build upon the reforms made under the Affordable Care Act (ACA), short of more comprehensive, Medicare for All–type reforms.

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