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Basic health program: state administration of basic health programs; eligibility and enrollment in standard health plans; essential health benefits in standard health plans; performance standards for basic health programs; premium and cost sharing for basic health programs; federal funding process; trust fund and financial integrity. Final rule



Basic health program: state administration of basic health programs; eligibility and enrollment in standard health plans; essential health benefits in standard health plans; performance standards for basic health programs; premium and cost sharing for basic health programs; federal funding process; trust fund and financial integrity. Final rule



Federal Register 79(48): 14111-14151



This final rule establishes the Basic Health Program (BHP), as required by section 1331 of the Affordable Care Act. The BHP provides states the flexibility to establish a health benefits coverage program for low-income individuals who would otherwise be eligible to purchase coverage through the Affordable Insurance Exchange (Exchange, also called Health Insurance Marketplace). The BHP complements and coordinates with enrollment in a QHP through the Exchange, as well as with enrollment in Medicaid and the Children's Health Insurance Program (CHIP). This final rule also sets forth a framework for BHP eligibility and enrollment, benefits, delivery of health care services, transfer of funds to participating states, and federal oversight. Additionally, this final rule amends another rule issued by the Secretary of the Department of Health and Human Services (Secretary) in order to clarify the applicability of that rule to the BHP.

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Accession: 051760253

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PMID: 24693564


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