Under the ACA, states are allowed the option of creating a Basic Health Plan (BHP) for low-income adults who earn too much to qualify for Medicaid.  Ordinarily, if these folks don’t have employer-sponsored coverage then come 2014 they will be able to buy insurance through the Exchange with the help of federal tax credits.  But, even with the tax credits this coverage may still be too expensive for them. The BHP then would act as a bridge between the free or low-cost Medicaid coverage and the higher priced options available on the Exchange.

Don’t be fooled by the name though – there is nothing “basic” about it.  According to the ACA, BHP coverage must be as affordable and comprehensive as what these adults would have gotten on the Exchange.  In New York, coverage would likely resemble that of the Family Health Plus program.

New York currently offers public coverage to low-income adults through its Family Health Plus program, the cost of which is split with the federal government.  New York also pays for Medicaid coverage for low-income immigrants without help from the federal government.  Through the BHP program, New York would be able to cover both of these groups and have the federal government pay for it all.  This would save the state between $500 million and $1 billion per year.

Sounds great, right? Problem is, the federal government still hasn’t released guidance on this program, and isn’t planning on doing so anytime soon.  Unfortunately, state policymakers won’t commit to the program until they are sure of all the details.  So, until that happens, it is unlikely that New York will get any of the cost-savings and affordability protections that the BHP has to offer.

HCFANY has created a policy brief on this issue to explain it in detail, urge federal policymakers to release BHP guidance, and provide recommendations to state policymakers.

Click here to read HCFANY’s policy brief, titled “The Basic Health Program Option in the Affordable Care Act.”