Health Reform’s Basic Health Plan

What is the Basic Health Plan (BHP)? Stan Dorn of the Urban Institute explains:

The Patient Protection and Affordable Care Act (ACA) offers states the option to implement the Basic Health Program (BHP). BHP gives states 95 percent of what the federal government would have spent on tax credits and subsidies for out-of-pocket costs for two groups:

  • Adults with income between 133 and 200 percent of the federal poverty level (FPL); and
  • Legally resident immigrants with incomes below 133 percent FPL whose immigration status disqualifies them from federally matched Medicaid.

If a state implements BHP, these two groups of consumers cannot receive subsidized insurance in the exchange. Instead, the state covers them by contracting with health plans or providers. Such contracts must provide at least the minimum essential benefits under ACA, and consumers may not be charged more than what they would have paid in the exchange.



1 Comment

Leave a Reply

Your email address will not be published. Required fields are marked *