Quantitative Evaluation of a Targeted Medicaid Buy-In for New Mexico

Prepared for Health Action New Mexico and the New Mexico Center on Law and Poverty, with support from the Laura and John Arnold Foundation

New Mexico, similar to a number of other states, is exploring a Medicaid buy-in product as part of a broader strategy to expand coverage and affordability of health insurance for residents. Medicaid buy-ins allow people above current Medicaid eligibility levels to pay a premium to receive healthcare coverage through a plan that leverages aspects of the state’s existing Medicaid program.

The New Mexico state legislature passed a directive to study the implications of offering a state-sponsored Medicaid buy-in to state residents. In accordance with this directive, Manatt Health—together with Health Action New Mexico, New Mexico Center on Law and Poverty, Partnership for Community Action, and Strong Families New Mexico—has published a two-part series of reports. For the first report, published in December 2018, Manatt conducted a qualitative assessment of several Medicaid buy-in options for New Mexico and crafted four potential buy-in options.

In this report, the second in the series, Manatt and its actuarial partner, Wakely Consulting Group, provide a quantitative evaluation of a targeted Medicaid buy-in, in which the state offers buy-in coverage—with financial assistance for lower-income individuals—outside of the Affordable Care Act individual market, to those currently ineligible for Marketplace or other coverage assistance. The analysis evaluates expected premiums for the buy-in product, its estimated enrollment and the state costs of providing financial assistance for individuals who lack access to affordable coverage, such as those earning below 200% of the federal poverty level who are impacted by immigration status.

Click here to read the full report.

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