Basic Health Plan

New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves 1.2 million New Yorkers, or over 4x as many residents as ACA exchange plans do.

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.

It's been about five months since I last posted about the status of Oregon's pending Basic Health Plan program:

As reported by Megan Messerly of Politico in 2022:

In Oregon, Democrats passed a bill in March to establish a basic health program, the details of which are being ironed out by a task force that began meeting this week. In Kentucky, Republicans approved $4.5 million in state funds this spring to set up a basic health program, which was signed into law by the state’s Democratic governor. An estimated 85,000 Oregonians and at least 37,000 Kentuckians will be eligible to enroll in the plans as soon as next year.

New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.

via New York State of Health:

  • Nearly Three Quarters of New Yorkers Enrolled in Medicaid, Child Health Plus or the Essential Plan Have Renewed Their Coverage by the June Deadline; Renewal Strategies Are Working; Others Still Have Time to Act
  • New York Outperforming National Average as Reported by KFF
  • Monthly Dashboard Tracks Renewal Status, Demographics, and State Program Transitions During Public Health Emergency Unwind  

ALBANY, N.Y. (July 18, 2023) – The New York State Department of Health today released the first issue of New York’s Public Health Emergency Unwind Dashboard, a monthly report reflecting data on renewal status, demographics, and program transitions for public health insurance enrollees, which shows renewal outreach strategies are working.  The report indicates that roughly 72 percent of New Yorkers enrolled in Medicaid, Child Health Plus or the Essential Plan renewed their coverage before the June deadline to re-enroll and those who haven’t still have time to act to avoid potential lapses in coverage. As reported by KFF, the national renewal rate for states reporting data is 59 percent.

As I wrote about back in March and updated in May, New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.

This is an updated version of a similar post from last month, when the legislation passed the MN Senate.

As I've written about several times, recently New Mexico passed (and Gov. Lujan Grisham signed) the first "true" Public Option bill, which will allow any permanent New Mexico resident to enroll in Medicaid regardless of income via a sliding premium scale. Today there's big Public Option news in another state: Minnesota.

The main distinction between the New Mexico and Minnesota approaches has to do with which existing publicly-funded healthcare program they're based on. While New Mexico went with Medicaid (which half the state's population is already enrolled in anyway), Minnesota is basing theirs on their Basic Health Plan program, MinnesotaCare. I first wrote about this back in February.

New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over eleven times as many people as Minnesota's "MinnesotaCare" program does (around 1.1 million vs. 100K). Part of this is obviously due to New York having a larger population, but that's only part of it (NY has 19.84M residents, just 3.5x higher than MN's 5.71M).

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

About a year ago, I noted that the state of Oregon had passed a bill which, if the federal waiver is approved by the federal government, would make them the third state in the U.S. to establish a Basic Health Plan program under the Affordable Care Act. As reported by Megan Messerly of Politico at the time:

In Oregon, Democrats passed a bill in March to establish a basic health program, the details of which are being ironed out by a task force that began meeting this week. In Kentucky, Republicans approved $4.5 million in state funds this spring to set up a basic health program, which was signed into law by the state’s Democratic governor. An estimated 85,000 Oregonians and at least 37,000 Kentuckians will be eligible to enroll in the plans as soon as next year.

via NY State of Health:

  • Since March 2020, Aligned with Federal Continuous Coverage Requirements, Enrollment in NY State of Health Programs has Grown by 41 Percent
  • As the Post-Public Health Emergency Redetermination Process Begins, State Has Deployed Multi-pronged Strategy to Maximize Number of Consumers who Maintain Coverage

ALBANY, N.Y. (April 20, 2023) – NY State of Health, the state’s official health plan Marketplace, today released the 2023 Health Insurance Coverage Update, a detailed summary of NY State of Health enrollment, including demographics, quality measures, and the cost savings realized by millions of New Yorkers who have comprehensive health insurance through the Marketplace.  As of January 31, 2023, NY State of Health enrollment is nearly 6.9 million, or more than one in three New Yorkers across the state.

Read the Marketplace’s 2023 Health Insurance Coverage Update here.

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