State Public Option Act

Summary · Congressional Research Service (nonpartisan)

This bill allows residents who are not already eligible for Medicaid and not concurrently enrolled in other health insurance coverage to buy into a state Medicaid plan beginning January 1, 2026, at the option of the state. State Medicaid programs may set premiums and cost-sharing requirements for such coverage in accordance with specified limitations. The bill also (1) provides the enhanced Federal Medical Assistance Percentage (i.e., federal matching rate) to every state that expands Medicaid coverage for individuals who are newly eligible under the Patient Protection and Affordable Care Act, regardless of when such expansion takes place; and (2) requires state Medicaid programs to cover comprehensive sexual and reproductive health care services, including abortion services.