Basic Health Program

The Affordable Care Act Offers States Another Option Besides Medicaid and the Exchanges for Health Coverage for Low-Income Residents.

A doctor checks out a patient in an examination room.

Having stable health insurance helps people obtain the medical care they need when they need it.

Being able to remain with the same health plan and providers also promotes continuity in relationships with providers, which has been linked to higher-quality care. The Affordable Care Act (ACA) employs two main strategies for expanding health insurance coverage—first, by providing incentives for states to extend Medicaid coverage to millions more low-income people, and second, by allowing better-off people to purchase private health insurance through new health insurance exchanges or Marketplaces.

In addition to these primary avenues, the law also provides an additional means of expanding coverage, by allowing states to run a Basic Health Program. Under such a program, states can offer public health insurance, beginning in 2015, to people whose incomes are too high to qualify for Medicaid but are below 200 percent of the federal poverty level.

To help pay for benefits under this program, states are eligible to receive the federal dollars that would otherwise go to subsidizing the purchase of private insurance coverage for those people through exchanges.


This issue brief is an update to the November 15, 2012 Basic Health Program brief.