Filed Under:Health Insurance, Individual Health

Working poor could get a new type of plan

The Centers for Medicare & Medicaid Services (CMS) has drafted regulations for a program that could help some states crowd commercial insurers out of directly serving the health coverage market for the working poor.

CMS is getting ready to publish the "Basic Health Program" (BHP) draft regulations Wednesday in the Federal Register.

CMS wrote the regulations to implement Section 1331 of the Patient Protection and Affordable Care Act (PPACA).

Some moderate, purple states have been trying to insure the working poor by using federal Medicaid expansion money to help residents buy private exchange coverage.

The BHP system would give other states a tool they could use to move in the opposite direction.

In those states, policymakers who think government health plans are more efficient than private plans could use the BHP system to offer a Medicaid-like or Medicare-like program for the working poor.

Moderate-income people in those states would pay for coverage from a government-run BHP plan rather than using federal subsidies to buy commercial health coverage through the new PPACA public exchange system.

Officials seem to assume in the draft regulations that state BHP managers would get the health coverage provided from private health insurers, health maintenance organizations or provider networks, and that most states would offer people a choice of at least two BHP "standard health plan" options.

A state can "enter into a regional compact with other states for joint procurement of standard health plans," officials say.

Regions with a state also could form compacts with other states, or regions in other states, officials say.

See also:

Featured Video

Most Recent Videos

Behind the scenes with Vicki Gunvalson [VIDEO]


In this exclusive interview, Vicki Gunvalson shares how she built a $15 million a year annuity business by planning for...

Regulator: Market may need to reinvent LTCI


Cioppa says Maine's governor wants to spur the creation of better products.

Dementia: It's more than Alzheimer's


An association calls for policymakers to remember lesser-known neurodegenerative conditions.

Protesters Disrupt WellPoint Annual Meeting


Hecklers call for more disclosures of information about political contributions.

Related resources

More Resources


Power your business with up-to-the-minute insurance news, analysis, and best practices from LifeHealthPro Daily eNewsletter – FREE.

Power your business with LifeHealthPro Daily eNewsletter – FREE.

Enter a valid email address.
Nichole Morford

Nichole Morford
Managing Editor

Thank you for subscribing to LifeHealthPro Daily!

Check Out More eNewsletters Now! Close

Advertisement. Closing in 15 seconds.