Hidden gem of the Affordable Health Care Act: The Basic Health Program

| June 13, 2012

Heard much about the Basic Health Program (BHP)? Created by the Affordable Care Act (ACA), the BHP may help low-income people with HIV to maintain continuity of care as their income changes from year to year. The BHP is another option for advocates to learn about as health care reform implementation moves forward in the states.

What is the Basic Health Program?

The BHP is a provision of the ACA that allows states an alternative coverage option that is similar to Medicaid. Very low-income people whose income is below 138% of FPL will be able to enroll in the Medicaid program. But for individuals with income between 138-200% of FPL, the Basic Health Program would offer coverage that is significantly less expensive than insurance purchased through the exchange.

The Urban Institute recently released a report about the BHP and what effects it could have on client out-of-pocket costs if implemented.

  • Adults with incomes between 138% and 200% of the federal poverty level would see their average annual premium payments drop from $1,218 to $100.
  • Out-of-pocket costs would decline from $434 to $96 a year.
  • BHP would thus reduce annual health care costs for low-income adults by an average of $1,456.

According to an analysis by Community Catalyst, the BHP would be particularly helpful for people who hover just above the cut-off for Medicaid and legal immigrants who are low-income but do not qualify for Medicaid because of their immigration status.

Hopefully this promising diamond in the rough is about to have a shining moment, and Washington and Massachusetts are leading the way.

Why is this important for the AIDS/HIV community?

According to the federal Department of Health and Human Services, only about 13% of people living with HIV have private health insurance, and nearly one quarter of people living with HIV have no insurance at all. BHP could help low-income people with HIV obtain more affordable health coverage, which would reduce financial barriers to care and allow people with HIV to access health care more consistently.

What’s the latest with the BHP?

According to Community Catalyst, Massachusetts has advanced proposals to adopt a BHP for the state, and it could be authorized for implementation by the legislature as early as July. In Washington state, the legislature passed an Exchange bill that includes provisions for a BHP.

With these two states shining a light on the Basic Health Program concept, we can only hope that other states give this hidden gem a chance!


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Category: HIVHealthReform.org Blog

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