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    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.

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    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)

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    Has your state completed this step toward health reform implementation? Share your work here.
    Get ideas from your peers here if your state is still gearing up to complete this step.

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    Tracking Medicaid Expansion Decisions: A Closer Look at Legislative Activity

    Learn more than just where Medicaid's expanding and where it isn't. This chart has information on cost sharing, premium assistance, and other details.

    upcoming webinar

    Stocking the Shelves: Exchanges Work to Certify Health Plans
    Wed., May 29 | 2:30 - 4 PM EDT

    Explore the key elements—benefit design, consumer protections, actuarial value, network adequacy, marketing requirements, accreditation, rates, and more—of certifying health plans for the exchange.

    potential plan rates become available

    Rates have been submitted to these states, and are available for åpublic comment. They may change before becoming final.

    Maryland: Health Insurance Rate Reviews Web Page, a list of spreadsheets

    Rhode Island: Proposed Insurance Rates, a list of spreadsheets

    Oregon: Standard Plan Rate Examples

    Vermont: Initial QHP Rate Filings

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