Child buy-in programs allow families with incomes in excess of a state’s Medicaid/SCHIP eligibility levels to purchase insurance for their children through the public plan. This short brief reviews state child buy-in programs, and provides an overview of issues that states must consider when implementing a program. It shows that while enrollment in the programs has been limited to date, they have the potential to play an important role in reaching universal coverage for children—if it is coupled with strategies to make the premiums affordable for families.

See also State Buy-In Programs: Prospects and Challenges (PDF), The Urban Institute, November 2008.