Using Medicaid to Wrap Around Private Insurance: Key Questions to Consider

Issue Brief
  1. Data for the remaining state was unavailable.

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  2. Cost-effectiveness requires the total cost of Medicaid premium assistance (including premiums, administrative costs, cost-sharing wraps and benefits wraps) to be comparable to cost of providing direct coverage through the Medicaid state plan. Additional factors can be taken into account when determining cost-effectiveness under Section 1115 waivers, such as savings from reduced churn between Medicaid and the Marketplace as enrollees’ income fluctuates and the effect of increased Marketplace enrollment and competition due to Medicaid premium assistance.


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