Damages resulting from coastal and riverine flooding in the United States exceed $32 billion annually and cause accelerating societal impacts, with disproportionate disruptions to the lives and livelihoods of vulnerable populations. Two approaches for flood risk mitigation include managed retreat from flood-prone areas, implemented in US buyout programs, and the construction of nature-based solutions (NBS). This study considers how buyout patterns change under an NBS-focused approach that explicitly removes the political process in selecting a buyout location and instead targets parcels within the floodplain based solely on post-acquisition wetland restoration suitability. The findings of this study reveal a key, multidimensional trade-off associated with buyout targeting in terms of environmental, economic or financial, and social equity.