; exceeds (ii) the total amount expended by the State during such year as medical assistance for individuals who buy into Medicaid coverage under subclause (XXIII) of section 1902(a)(10)(A)(ii) of such Act (as added by this Act). (d) Cost-Sharing requirement Section 1916 of the Social Security Act ( 42 U.S.C. 1396o ) is amended by adding at the end the following new subsection: (k) Premiums and cost-Sharing for individuals participating in Medicaid buy-In program (1) In general Subject to paragraph (2), with respect to individuals who are eligible for medical assistance under subsection (a)(10)(A)(ii)(XXIII) of section 1902 and are described in subsection (nn) of such section, a State may— (A) impose premiums, deductibles, cost-sharing, or other similar charges that are actuarially fair