Improving the Affordability of Coverage through the Basic Health Program in Minnesota and New York
Issue Brief
Minnesota Budget Project, Basic Health Plan Offers a Chance to Provide Comprehensive Health Care Coverage for Low-Income Minnesotans (St. Paul, MN: Minnesota Budget Project, January 2012), http://www.mnbudgetproject.org/research-analysis/economic-security/basic-health-plan
Minnesota Department of Health Services, Prepaid Medical Assistance Project Plus (PMAP+) Section 1115 Waiver Evaluation Plan 2014 (Minnesota Department of Health Services, 2014), http://dhs.state.mn.us/main/groups/healthcare/documents/pub/dhs16_194875.pdf
Editorial Board, “A next-generation model for MinnesotaCare,” Star Tribune, (May 2013), http://www.startribune.com/a-next-generation-model-for-minnesotacare/208894751/
Ibid.
New York State of Health. NY State of Health Essential Plan Webinar, (New York State of Health, November 16, 2015), http://info.nystateofhealth.ny.gov/sites/default/files/Essential%20Plan,%2010-7-15.pdf
“State Moves Forward with BHPs,” Greater New York Hospital Association, (August 2015), http://www.gnyha.org/PressRoom/Publication/f4baa92a-cec4-4f90-a945-c6e2aa2f6198/
New York requires insurers to follow the BHP naming convention in naming their products to ensure that consumers can easily identify BHP plans. “Essential Plan 1” is the product for individuals with incomes between 150 and 200% FPL, “Essential Plan 2” is the product for individuals with incomes between 138 and 150% FPL, “Essential Plan 3” is the product for individuals with incomes between 100 and 138% FPL who are not eligible for Medicaid due to immigration status, and “Essential Plan 4” is the product for individuals with incomes at or below 100% FPL who are not eligible for Medicaid due to immigration status.
2017 Invitation for Participation in New York State of Health, Attachment F – BHP Product Offering and Cost-Sharing (New York State of Health, 2015), http://info.nystateofhealth.ny.gov/sites/default/files/Attachment%20F%20-%20BHP%20-%20Benefits%20and%20Cost-Sharing,%205-15-15.pdf
Minnesota Department of Human Services, MinnesotaCare Premium Estimator Table, (Minnesota Department of Human Services, 2015), https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4139A-ENG
Individuals under age 21, American Indians and Alaska Natives and their family members are exempt from premiums, and members of the military who have completed a tour of active duty within 24 months and their family members are exempt from premiums for 12 months. Medicaid.gov, Minnesota’s Basic Health Program Blueprint, (Medicaid.gov, April 2016), https://www.medicaid.gov/basic-health-program/downloads/minnesota-bhp-blueprint.pdf
Because neither Minnesota nor New York enrolled BHP individuals into the marketplace in 2016, a direct comparison of what those individuals would have paid in premiums is not possible. The estimates included in the Table are based on a household size of 1. While the estimates were calculated based on the US average premium for a single adult age 40, the actual consumer costs at the applicable income levels are based entirely on family income when consumers purchase benchmark-priced coverage. Source: Kaiser Family Foundation, 2016 Health Insurance Marketplace Calculator, https://www.kff.org/interactive/subsidy-calculator-2016/
Randall Chun, MinnesotaCare Information Brief, (St. Paul, MN: Research Department of the Minnesota House of Representatives, January 2016), http://www.house.leg.state.mn.us/hrd/pubs/mncare.pdf
Minnesota Department of Human Services, Bulletin: Legislative Changes to Medical Assistance and MinnesotaCare, Minnesota Department of Human Services, July 2015, http://www.dhs.state.mn.us/main/groups/publications/documents/pub/dhs16_195870.pdf
New York State of Health, Invitation and Requirements for Insurer Certification and Recertification for Participation in 2016 (NY State of Health, May 2015), http://info.nystateofhealth.ny.gov/sites/default/files/2016%20Invitation%20to%20Participate%20in%20NYSOH%2C%205-15-15.pdf
New York State of Health, Invitation and Requirements for Insurer Certification and Recertification for Participation in 2016 (NY State of Health, May 2015), http://info.nystateofhealth.ny.gov/sites/default/files/2016%20Invitation%20to%20Participate%20in%20NYSOH%2C%205-15-15.pdf
Minnesota Department of Human Services, MinnesotaCare Health Plan Choices by County (Minnesota Department of Human Services, January 2016) https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4326-ENG
The NY State of Health: Official Health Plan Marketplace, 2016 Open Enrollment Report, (August 2016) http://info.nystateofhealth.ny.gov/sites/default/files/NYSOH%202016%20Open%20Enrollment%20Report%282%29.pdf
Authors’ calculations, The NY State of Health: Official Health Plan Marketplace, 2016 Open Enrollment Report, (August 2016) http://info.nystateofhealth.ny.gov/sites/default/files/NYSOH%202016%20Open%20Enrollment%20Report%282%29.pdf; The NY State of Health: Official Health Plan Marketplace, 2015 Open Enrollment Report, (July 2015), http://info.nystateofhealth.ny.gov/sites/default/files/2015%20NYSOH%20Open%20Enrollment%20Report.pdf
Peter Newell and Nikhita Thaper. New York’s Temporary Premium Subsidies: Meeting Immediate Goals and Yielding Useful Lessons. United Health Fund, June 2016. https://www.uhfnyc.org/assets/1492
The NY State of Health: Official Health Plan Marketplace, 2016 Open Enrollment Report, (August 2016), http://info.nystateofhealth.ny.gov/sites/default/files/NYSOH%202016%20Open%20Enrollment%20Report%282%29.pdf
Ibid.
Ibid.
Minnesota Department of Human Services, Managed care enrollment figures, available at: http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_141529#.
Randall Chun, MinnesotaCare Information Brief, (St. Paul, MN: Research Department of the Minnesota House of Representatives, January 2016), http://www.house.leg.state.mn.us/hrd/pubs/mncare.pdf
MNsure, MNsure FY 2017 Preliminary Budget—Explanation of Funding Sources and Expenditures, (St. Paul, MN: MNsure, March 2016), https://www.leg.state.mn.us/docs/2016/mandated/160417.pdf
Centers for Medicare and Medicaid Services. “Basic Health Program: State Administration of Basic Health Programs; Eligibility and Enrollment in Standard Health Plans; Essential Health Benefits in Standard Health Plans; Performance Standards for Basic Health Programs; Premium and Cost Sharing for Basic Health Programs; Federal Funding Process; Trust Fund and Financial Integrity.” Federal Register. Vol. 79, No. 48 (March 12, 2014): 14112-14151 at 14133, http://www.gpo.gov/fdsys/pkg/FR-2014-03-12/pdf/2014-05299.pdf, as discussed in Stan Dorn and Jennifer Tolbert, The ACA’s Basic Health Program Option: Federal Requirements and State Trade-Offs, (Kaiser Commission on Medicaid and the Uninsured and the Urban Institute, November 2014), https://www.kff.org/health-reform/report/the-acas-basic-health-program-option-federal-requirements-and-state-trade-offs/
Andrew M. Cuomo and Robert F. Mujica Jr., FY 2017 Enacted Budget Financial Plan, (New York State of Opportunity, May 2016) https://www.budget.ny.gov/budgetFP/FY2017FP.pdf.
Minnesota Management and Budget, Health Care Access Fund, February 2016 Forecast Update, (Minnesota Management and Budget, February 2016), https://mn.gov/mmb/assets/feb16fcst-hcaf_tcm1059-157696.pdf
