Exploring the Role of the Basic Health Plan Option in New York State

Grantee Name

Community Service Society of New York

Funding Area

Expanding Health Care Coverage

Publication Date

December 2012

Grant Amount

$290,750

Grant Date:

September 17, 2010 – December 27, 2011

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Many individuals and families find themselves with too few health care options, earning income that is too high to qualify for Medicaid coverage but too low to afford private health insurance.

Federal health reform gives every state the option to establish a Basic Health Plan (BHP)—a public coverage program for individuals with incomes just above the Medicaid income cut-off and less than 200% of the Federal poverty level. If New York State chooses to implement a BHP, eligible individuals would receive their insurance coverage through a BHP instead of receiving subsidies to purchase private coverage through the new health insurance exchange. However, careful analysis was needed to help the State fully understand the implications of creating a BHP and to make informed decisions.

In September 2010, the New York Health Foundation (NYHealth) awarded the Community Service Society of New York (CSS) a grant to conduct this analysis along with two partners, Gorman Actuarial and Manatt Health Solutions.

Outcomes and Lessons Learned

CSS, in partnership with Gorman Actuarial and Manatt Health Solutions, accomplished the following:

Conducted an analysis of the existing BHP in Washington State, the Federal law, and Federal guidance, and an assessment of their implications for New York State.
Completed a fiscal analysis of the adequacy of Federal financing offered under the Affordable Care Act in the context of New York State.
Identified and assessed various program design issues—including benefit packages, premiums, and reimbursement rates.
Published the NYHealth-funded public report, “Bridging the Gap: Exploring the Basic Health Insurance Option for New York.”
Met with officials from the New York State’s Governor’s Office, the State Department of Insurance, and associates from the Urban Institute to discuss and compare CSS’s BHP analysis with a similar study performed for the State by the Urban Institute.

Read the report associated with this grant, “Bridging the Gap: Exploring the Basic Health Insurance Option for New York”.

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