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CMS Releases Proposed Rule for the Establishment of the Basic Health Program

Wednesday, October 02, 2013

On September 20, 2013, the Centers for Medicare & Medicaid services issued a proposed rule providing states the option of establishing a Basic Health Program. The Basic Health Program is intended to provide health insurance to low-income individuals who have income less than 200% of the federal poverty level, but do not qualify for Medicaid, the Children's Health Insurance Program, or other minimum essential coverage.

Under section 1331 of the Affordable Care Act, states have the option to establish a Basic Health Program. States that choose to operate the program will receive federal funding equivalent to 95% of the premium tax credits and the cost sharing reductions that would have been provided to the individual if they purchased insurance through the Health Insurance Marketplace. The proposed rule outlines key provisions which include state establishment of a Basic Health Program, eligibility and enrollment, standard health plan, enrollee financial responsibilities, financing of the Basic Health Program, and program oversight.

Public comments on the proposed rule are due November 25, 2013.  Instructions on submitting comments about the proposed rule can be found in the Federal Register.

Read the proposed Rule.

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