(1) Medicaid premium assistance is not widely used today, and there are limited data on how well it works. (2) Blending Medicaid and private insurance is administratively complex for states, and some states have discontinued their programs. (3) Details about a new Senate proposal to use Medicaid funds to wrap around private insurance subsidized with federal tax credits are unclear and changing but seem to provide federal funding through Section 1115 waivers, which are granted at the discretion of the HHS Secretary and must be budget neutral to the federal government, leaving states with no guarantee of funding amounts or longevity.
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