In a rather unusual fashion, the federal Centers for Medicare and Medicaid Services (CMS) announced earlier this month that one of the major provisions in the Affordable Care Act (ACA) will be delayed until 2015. The Basic Health Program, as it is called, would provide subsidized health care coverage to individuals with low incomes who do not qualify for the ACA’s Medicaid expansion, which requires states to cover childless adults with incomes up to 133% of the federal poverty level (FPL) beginning January 1, 2014. Individuals seeking coverage under the Basic Health Program would (1) be covered if their income was less than 200% of the FPL and (2) not be eligible to receive insurance coverage through a state’s health insurance exchange.
States had been waiting for CMS to issue guidance on the Basic Health Program, which was supposed to be up and running in 2014, but the federal agency is now telling states that it expects to issue such guidance sometime later this year, and final guidance in 2014. In the interim, CMS indicates that it is working with states that are interested in creating programs like the Basic Health Program that could help them cover the target population.
The announcement was unusual because it came in the form of a “Q and A” entitled “Medicaid and the Affordable Care Act,” not as a formal letter from CMS to states as is the norm.
In 2012, the Connecticut legislature considered two bills that would have created a Basic Health Program but neither passed. In the interim, a working group looked at the feasibility of Connecticut having such a program. In December 2012, the group recommended delaying a decision to adopt a Basic Health Program until there is additional information to evaluate costs and benefits. It cited the lack of CMS guidance as a factor in reaching its conclusion.
