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PPACA program appeals to Medicaid expansion fans

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The U.S. Department of Health and Human Services (HHS) is renewing the paperwork clearance it and states need to set up a new type of health plan aimed at the working poor.

At least one state — Minnesota — has posted a draft blue print for a Patient Protection and Affordable Care Act (PPACA) Basic Health Program.

Some states that hate the idea of expanding Medicaid are using PPACA Medicaid expansion money to help people who earn too much to qualify for Medicaid, but earn too little to afford qualified health plan (QHP) coverage, to help those moderate-income people buy QHP coverage through the public health insurance system.

The PPACA Basic Health Program section — Section 1331 encourages states to take the opposite approach. It encourages states to use PPACA QHP subsidy money to help moderate-income people buy Medicaid coverage. Minnesota already had a homegrown Medicaid buy-in program before PPACA came along, and advocates say using a state’s bargaining power will help the Basic Health Program plan members get better, cheaper coverage than they could get through a PPACA exchange.

See also: Feds flesh out big new PPACA program

The Centers for Medicare & Medicaid Services (CMS), an arm of HHS, has not said much about the Basic Health Program, but it recently got the Office of Management and Budget (OMB) to renew approval for the efforts to gather the information CMS and states will need to set up Basic Health Program plans.

The Minnesota Department of Human Services is asking for comments on the draft it created for turning its basic health plan into a PPACA-compliant, federally funded Basic Health Plan. A year ago, some state and federal officials were saying they would go slow on setting up Basic Health Program plans because of concerns that competition from the plans would hurt the launch of the PPACA public exchange system.

In the draft blue print, Minnesota officials sketch out the process they would use to move people between QHPs and Basic Health Program plans, but officials don’t talk about how the state basic health program has affected the state’s exchange program and exchange plan issuers, or how a PPACA-compliant Basic Health Program might affect the exchange and its QHP issuers.

Officials in California, Hawaii, New York state and West Virginia have also talked about setting up Basic Health Program plans.


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