Low-cost Insurance Option Could Save States Money

By Dana Spector, Associate Managing Editor, AHC Media

Where did you get your health insurance? An employer? The marketplace? Other? Last month, more than 350,000 New Yorkers received their health insurance through something called a “basic health program,” which is designed to provide coverage to residents of limited means.

The Affordable Care Act (ACA) contains a provision allowing states to create such programs and make them available to low-income individuals and families, who meet certain criteria. For many, basic health programs are a better bargain than marketplace plans, and still cover these 10 essential health benefits (just like marketplace plans).

Before the ACA, Americans who would qualify for basic health programs received Medicaid. Transitioning applicable residents from Medicaid to basic health programs could save states a lot of money. Still, some states anticipate using other strategies to save even more money, such as the state innovation waiver program.

Interestingly, the large number of people exiting the marketplace for basic health plans could shift the marketplace’s interactions with insurers. Follow up on how basic health programs and the marketplace are performing (and more) in AHC Media’s Hospital Peer Review.