ACA's Basic Health Program gains traction in some states

February 2, 2016 | By Katherine Moody

In New York and Minnesota, a combined 475,000 low-income individuals have signed up for health plans that are even more affordable than subsidized marketplace coverage through the Affordable Care Act's Basic Health Program. Yet it may not be likely for other states to adopt the same program, according to an article from Kaiser Health News.

The system targets people who are just above the Medicaid cutoff as well as low-income legal immigrants who are not eligible for Medicaid because they haven't been in the country for five years. People who are eligible for the program cannot go to the marketplace to get subsidized coverage, the article notes.

The article explains that while on New York's Essential Plan, someone with an income of $23,540 would pay a monthly premium of $20 for a plan with no deductible and $15 copayments for primary care doctor visits. The least expensive standard silver-level marketplace plan in New York County for someone with an annual income of $24,000, even with a $237 premium tax credit, has a monthly premium is $131 with a $1,500 deductible and $30 copayments for primary care doctor visits.

The Basic Health Program, however, may not be good fit elsewhere in the country. People with incomes that are less than 200 percent of the federal poverty line make up as much as two-thirds of marketplace enrollment in some states, and a smaller marketplace might be less attractive to insurers and result in fewer, more expensive offerings on the exchanges, KHN says.

"If you pull those people out, you've decreased the size of the marketplace significantly, and that has the potential to change way the insurers look at it," Linda Blumberg, a senior fellow at the Urban Institute's Health Policy Institute, tells KHN.

Recently, House Republicans have also taken issue with the Basic Health Program, claiming that funding for the program was never approved by Congress.

To learn more:
- here is the KHN article