Medicaid expansion passes in Montana, Basic Health Program launched in New York

After one botched vote, two years and an all-out resistance blitz by the Koch Bros and their ilk which was so obnoxious that they managed to alienate local Republicans, the Medicaid expansion provision of the Affordable Care Act has finally officially passed both the state House and Senate of Montana, and should be signed into law by the Democratic governor any moment now.

HELENA (AP) – The state Legislature has passed a bill expanding Medicaid eligibility to about 70,000 low-income Montana residents.

The bill approved Saturday heads to Gov. Steve Bullock, who is expected to sign it into law.

Meanwhile, New York State of Health (NY's ACA exchange) has announced that they're becoming the 2nd state to launch a Basic Health Program (BHP) via a different provision of the Affordable Care Act.

ALBANY (April 17, 2015) - NY State of Health (NYSOH) the state’s official health plan Marketplace, today announced a new program that will give New York State the flexibility to design private health insurance coverage specifically for New Yorkers with certain income levels. This innovative Basic Health Program (BHP) is one of only two programs nationwide to receive federal approval under the Affordable Care Act.

“We are excited to be among the first states in the nation to implement this option and we extend our thanks to the federal Centers for Medicare and Medicaid Services for their partnership,” said NYSOH Executive Director Donna Frescatore. “Adding the Basic Health Program to the suite of health insurance options already available through New York State of Health will make coverage even more affordable for hundreds of thousands of New Yorkers.”

The BHP will offer qualified individuals and families a choice of plans from high-quality, private health insurers through NY State of Heath (NYSOH), the state’s official health plan Marketplace. New York State health insurers were invited to offer plans through the BHP when the NYSOH plan invitation was issued today to New York State licensed health insurance companies. The invitation includes requirements for insurer certification and recertification for Qualified Health Plans and Stand-Alone Dental Plans, and for the new Basic Health Program which will start on January 1, 2016. 

Until now, Minnesota was the only state to have implemented such a program via MinnesotaCare, although the program itself has actually been around for far longer than the ACA itself (it was started way back in 1992).

Congratulations to both Montana and New York for these developments!

UPDATE: For those wondering exactly what distinguishes "BHPs" from "QHPs" sold via the exchanges, Andrew Sprung has a good overview:

A BHP is a low-cost, low-premium offering for buyers with incomes between the Medicaid eligibility cutoff (100% or 138% of the Federal Poverty Level*) and 200% FPL.   The premiums and cost-sharing compare very favorably with the mainstream private health plans offered on ACA exchanges as previously priced for low-income buyers. New York's BHP will have two tiers, with virtually no cost for plan holders with incomes between 100% and  150% FPL and just a $20 monthly premium and minimal cost-sharing for buyers in the 150-200% FPL range.

The 100% FPL starting point presumably means that the upper end prior Medicaid-eligibles (100-138% FPL) will be transitioned in. The benefit summary is below the jump. The plans will be available in 2016; enrollment will begin in November. The state will contract with private insurers to deliver the benefits.

...By way of comparison, a single person earning just under 200% FPL and buying a private health plan on an ACA exchange anywhere in the country will pay $119 per month for the second cheapest silver plan, which typically will carry a deductible, reduced by the Cost Sharing Reduction subsidies available only with silver plans,  ranging from $0 to $1500.

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