Here's what Manhattan freelance writer Marcella Durand feared when she went to an Affordable Care Act enrollment counselor for 2016 health insurance: a “terrible premium with a terrible deductible for a plan that covered nothing.” Instead, she says she was “absolutely surprised” by an option she knew nothing about.
Durand signed up herself, her husband, who's a freelance artist, and their young son for New York State's new Essential Plan. Her family will pay $49 a month for a plan through Empire Blue Cross and Blue Shield that has no deductible and covers most of their regular providers. They were previously paying $500 a month for an exchange plan with a $3,500 deductible. “I can't tell you how relieved we were,” she said.
On Jan. 1, New York became the second state to launch a version of the Basic Health Program (BHP) option authorized by the ACA, serving people with incomes between 138% and 200% of the federal poverty level, plus legal immigrants who don't immediately qualify for Medicaid. Consistent with Durand's experience, the state's advertising slogan for the Essential Plan is “You'd be surprised.”
Minnesota took advantage of the program last year, shifting its longstanding MinnesotaCare program—which also covers legal immigrants—to a BHP. In both states, it is the sole subsidized insurance option for residents who fall into that defined income group.
The federal government pays the state programs 95% of the amount it otherwise would pay a state for premium tax credits and cost-sharing reductions for the targeted population. As of last month, New York reported that 356,000 residents had signed up for its Essential Plan, while Minnesota has 125,000 enrollees. New York says the plan will cost $2.6 billion for 2016-17, of which $2 billion will be covered by the federal government. Oregon lawmakers are now considering a bill to develop a BHP option for 2018.