Feds flesh out big new PPACA programNews added by Benefits Pro on April 22, 2014
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By Allison Bell

Obama administration officials are starting to create the framework for what could be another major health insurance program: the Basic Health Program.

A state that used the PPACA Basic Health Program could get money from the federal government to set up a voluntary, government-run, enrollee-paid health plan for the working poor.

The Centers for Medicare & Medicaid Services has released paperwork review analyses for a key component of the Basic Health Program -- information about the mechanics of how CMS and the U.S. Department of Health and Human Services -- would fund the new plan.

A state could finance its BHP by collecting an amount equal to 95 percent of what HHS would have spent on qualified health plan premium, deductible and coinsurance subsidies if the BHP enrollees had bought plan coverage through an exchange.

In practice, because people with very low incomes qualify for Medicaid, most of those eligible for BHP coverage would be more moderate-income people.

All 17 of the states who run their ow exchanges will probably apply to see how much federal funding they could get, officials write in the paperwork burden analysis.

HHS doesn’t need to collect similar data from the federal exchanges, because they already have it, officials say.

Because PPACA requires HHS to base plan premium and other subsidies on the cost of a market’s second cheapest silver-level plan, HHS would require states to provide “county or county equivalent” silver plan cost data.

HHS plans to ask for silver plan cost data for 21-year-olds, 35-year-olds, 45-year-olds and 55-year-olds, in both the tobacco user and non-tobacco-user classes.

CMS lists Chris Truffer as an individual consulted on statistical aspects of the information collection.

CMS might collect the required data by November 2014, and BHPs could start providing coverage for enrollees as early as Jan. 1, 2015, officials say.

CMS could start sending BHP cash to states in December.

Originally published on BenefitsPro.com
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