States may choose to establish a basic health program to provide coverage to low-income individuals. This option allows states to design benefits specifically for this population, different from those offered in either Medicaid or the Exchange.

*Milestone details:

*Full name: Decide whether or not to offer a state basic health program to offer coverage to people not eligible for Medicaid with household income of 133% - 200% FPL.

*Relevance to the ACA:

The ACA allows states to contract with health plans to provide coverage to individuals with household incomes that exceed 133% but not 200% of the FPL. If a state chooses this option, individuals eligible for the basic health program may not obtain coverage through the Exchange. A state basic health program must include at least the essential health benefits. For states that elect this option, the federal government will provide funds equal to 85% of the premium tax credits that enrolled individuals would have received had they had enrolled in plans through an Exchange. (§1331)