1. Basic Health Programs: An Alternative to Public Options?
- Author
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Zewde, Naomi, Drake, Coleman, and Biener, Adam
- Subjects
HEALTH programs ,MEDICAID ,SAFETY-net health care providers ,GOVERNMENT policy ,MEDICAL care costs ,INCOME ,PATIENT Protection & Affordable Care Act - Abstract
Issue: “Public option” health plans, particularly as enacted in Washington State, have had difficulty meeting their goals of improving affordability for patients and reducing overall health care costs. Some states have instead created a Basic Health Program (BHP), an alternative form of coverage authorized by the Affordable Care Act that replaces marketplace coverage for residents with low incomes who are eligible for premium subsidies. Goals: Analyze the evolution of Washington’s public option and policy changes made in other states in response to initial rollout challenges and compare these with the policy goals and outcomes of BHPs. Key Findings and Conclusion: Washington’s public option initially struggled with provider network participation and price competitiveness. Without sufficient network participation and robust enrollment, public options have few means to improve affordability or lower health care costs. BHPs are unlikely to face the same challenges. They contract with safety-net providers at Medicaid-like rates to cover all households with incomes between 138 percent and 200 percent of the federal poverty level who would otherwise be eligible for marketplace subsidies. A BHP can provide robust affordability with minimal out-of-pocket spending at a low cost to states and the federal government. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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