To date, Minnesota and New York are the only states to have adopted a Basic Health Program (BHP), an option in the Affordable Care Act (ACA) that permits state-administered coverage in lieu of marketplace coverage for those with incomes below 200% of the federal poverty level (FPL) who would otherwise qualify for marketplace subsidies. BHP covers adults with incomes between 138-200% of FPL and lawfully present non-citizens with incomes below 138% FPL whose immigration status makes them ineligible for Medicaid. This brief reviews Minnesota’s and New York’s approaches to BHP and assesses BHP’s impact on consumers, marketplaces, and state costs. Although there is uncertainty around the future of the ACA (including BHP) following the 2016 election, BHP implementation offers important lessons for consideration in future reforms about structuring coverage programs for low-income uninsured consumers.
- view as grid
- view as list
This brief describes health insurance subsidies available through the Affordable Care Act’s marketplaces, including premium subsidies that would be provided in the form of tax credits, as well as other subsidies that would lower cost sharing to eligible Americans. It provides details on who is eligible for the assistance, the maximum repayment limits for the credits, and out-of-pocket spending limits.
This fact sheet describes how coverage has changed under the ACA, examines the characteristics of the uninsured population, and summarizes the access and financial implications of not having coverage.
Modifying Traditional Medicare’s Benefit Design Could Reduce Federal Spending But With Cost Tradeoffs Between Beneficiaries and The Federal Government
Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes — but would be unlikely to achieve all of these goals simultaneously.
This report examines an approach to reforming Medicare that has been a focus of Congressional hearings and featured in several broader debt reduction and entitlement reform proposals, and was included in the June 2016 House Republican health plan. The analysis models four different options for modifying Medicare’s benefit design, all of which include a single deductible, modified cost-sharing requirements, a new cost-sharing limit, and a prohibition on first-dollar Medigap coverage. The analysis models the expected effects on out-of-pocket spending by beneficiaries in traditional Medicare, and assesses how each option is expected to affect spending by the federal government, state Medicaid programs, employers, and other payers, assuming full implementation in 2018.
This brief highlights low-income workers and the impact of ACA coverage expansions on this population. Low-income workers may not have access to jobs that provide full-time, full-year employment or jobs with comprehensive benefit packages, including health insurance. Medicaid plays an important role in providing health coverage for low-income workers, and coverage expansions implemented under the ACA have produced substantial coverage gains for low-income workers and a corresponding reduction in the uninsured. However, low-income workers in non-expansion states with incomes too high for Medicaid but too low for subsidies in the Marketplace do not have an affordable coverage option and will likely remain uninsured.
This brief highlights voices from adult focus group participants with low and moderate incomes who gained Medicaid or Marketplace coverage following implementation of the ACA. It focuses on work, including work status, the new labor market, job benefits, and the role of ACA coverage for those with non-traditional jobs.
Web Briefing – Serving the Homeless Community: New Findings on the Impact of the ACA Medicaid Expansion
On Tuesday, April 26, 2016, KFF presented a web briefing to examine new findings about how the Medicaid expansion has affected patients who are homeless, as well as the providers who care for them. The briefing addressed changes in insurance coverage, revenues and costs among Health Care for the Homeless (HCH) projects, a subset of community health centers that serve individuals who are homeless, in both expansion and non-expansion states, as well as examined experiences in health centers that serve a broad low-income population.
Characteristics of Remaining Uninsured Men and Potential Strategies to Reach and Enroll them in Health Coverage
This brief provides information on remaining nonelderly uninsured men ages 19-64, provides national estimates of their eligibility for ACA coverage options, and discusses strategies for reaching and enrolling them into health coverage.