• Hypertrophic Cardiomyopathy (HCM)
  • Eyecare
  • Urothelial Carcinoma
  • Hemophilia
  • Heart Failure
  • Vaccines
  • Neonatal Care
  • Type II Inflammation
  • Substance Use Disorder
  • Gene Therapy
  • Lung Cancer
  • Spinal Muscular Atrophy
  • HIV
  • Post-Acute Care
  • Liver Disease
  • Asthma
  • Atrial Fibrillation
  • COVID-19
  • Cardiovascular Diseases
  • Prescription Digital Therapeutics
  • Reproductive Health
  • The Improving Patient Access Podcast
  • Blood Cancer
  • Ulcerative Colitis
  • Respiratory Conditions
  • Multiple Sclerosis
  • Digital Health
  • Population Health
  • Sleep Disorders
  • Biosimilars
  • Plaque Psoriasis
  • Leukemia and Lymphoma
  • Oncology
  • Pediatrics
  • Urology
  • Obstetrics-Gynecology & Women's Health
  • Opioids
  • Solid Tumors
  • Autoimmune Diseases
  • Dermatology
  • Diabetes
  • Mental Health

Fact File: The Basic Health Plan


It's included in ACA Section 1331

What is the Basic Health Plan?

Regulation: The Basic Health Plan (BHP) program was included in the Affordable Care Act (ACA), Section 1331.

Eligibility: Consumers with incomes between 133% and 200% of federal poverty level, who would otherwise use tax credits to purchase coverage in the exchanges. Legal immigrants whose immigration status disqualifies them from Medicaid also are eligible.

Benefits: Plans must include the Essential Benefits. Enrollees cannot pay more in premiums or out-of-pocket than they would in the exchange.

Funding: The federal government would provide to the participating state 95% of what it would have otherwise spent on subsidies and cost-sharing reductions for the population. No matching funds from the state are required.

Goals: To reduce churning in and out of Medicaid and allow continuity of coverage; to offer additional cost protection for low-income consumers; to save money for states by moving the population into managed care rather than into Medicaid with a de facto federal block grant.

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