State Public Option Act
Senate Bill Would Let States Offer Medicaid Buy-In as Public Option for Uninsured Residents
Stalled
No legislative action in over 90 days.
Legislative Progress
Key Points
- This bill allows states to create a new health insurance choice by letting residents buy into the Medicaid program. This 'public option' would provide an alternative to private insurance plans for people who do not currently have coverage.
- People who join this plan would pay monthly premiums and other costs like deductibles. However, the bill limits total premiums to no more than 8.5% of a family's income to keep it affordable. Financial help, such as tax credits, would also be available to help lower-income families pay for the plan.
- The insurance would cover a wide range of medical needs, including primary care, hospital visits, and reproductive health services. It specifically requires coverage for sexual and reproductive health care, including abortion services.
- To ensure patients can find a doctor, the bill increases the amount Medicaid pays for primary care visits so it matches the higher rates paid by Medicare. This is intended to encourage more doctors to accept patients from this new plan.
- If the bill becomes law, states could start offering this new insurance option as early as January 1, 2026. The federal government would pay for 90% of the administrative costs to help states set up and run the program.
Impact Analysis
Personal Impact
Life & Work
The bill's requirement that Medicaid cover comprehensive sexual and reproductive health care services could expand access to important health services for LGBTQ individuals. Medicaid plans in participating states would need to provide a full range of reproductive health services, and the broader availability of affordable coverage through the buy-in could help LGBTQ individuals who face higher rates of being uninsured.
Programs
Disabilities
Milestones
Read twice and referred to the Committee on Finance.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in Senate
The bill was officially filed and given a number. It now enters the legislative queue.
Votes
No votes have been recorded for this legislation yet.
Related News
5 articles
Schatz Introduced State Public Option Act Today to Build on ACA's Progress, Provide Quality, Affordable Insurance Through Medicaid
Senator Brian Schatz reintroduced the State Public Option Act to allow states to create a Medicaid buy-in program for all residents. The bill requires states to cover sexual and reproductive health services, including abortion care, in all Medicaid buy-in plans to protect reproductive freedom.

Medicaid Explainer: Does Anyone Really Know How this Important Program Operates?
The article discusses the complexities of Medicaid and the push for a 'Medicaid Buy-In' plan in New Mexico. It notes that federal legislation like the State Public Option Act would provide the framework for states to offer Medicaid as a public option on the insurance marketplace.

Lawmakers Consider Affordable Medicaid Buy-in Program
West Virginia lawmakers are evaluating a state-level Medicaid buy-in program to help residents who earn too much for traditional Medicaid but cannot afford private insurance. This mirrors federal efforts like the State Public Option Act to bridge the 'cliff effect' in health coverage.
Source Information
Document Type
Congressional Bill
Official Title
State Public Option Act
Data Sources
Sponsor
Cosponsors
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