State Public Option Act

This bill creates a new Medicaid buy-in program allowing certain individuals to purchase Medicaid coverage starting January 1, 2026. It directly affects state residents who are not enrolled in other health insurance plans and meet income requirements, with premiums limited to 8.5% of household income. Key provisions include allowing individuals to use premium tax credits, providing states with enhanced federal funding (90% match) for administrative costs, and requiring states to update quality measures by 2030. The program would be structured similarly to private Marketplace insurance, with cost-sharing aligned with the Affordable Care Act. States would also be required to cover comprehensive sexual and reproductive health services as part of this Medicaid buy-in program.