Section 1331 in the Patient Protection and Affordable Care Act of 2010 (PPACA) is written to provide states with an alternative when insuring moderately low-income citizens through the new health insurance exchange. Some states may partner with  health insurers to offer a new type of plan—The Section 1331 Basic Health Program plan. The Centers for Medicare and Medicaid Services (CMS), part of the U.S. Department of Health and Human Services is asking states to talk about Section 1331 provisions in an effort to understand what factors and possible challenges would be considered when establishing a Basic Health Program.
The Section 1331 program is designed for people who earn too much to qualify for Medicaid but too little to easily afford insurance coverage. To be eligible for Section 1331, CMS identifies that an individual must:
- Be younger than 65 at the beginning of the plan year
- Have a household income between 133% and 200% of the federal poverty level
- Not be eligible for Medicaid or employer-sponsored coverage
Premiums for Section 1331 plan coverage are supposed to be comparable to what an individual could purchase through the exchange.
Comments on Section 1331 are due 45 days after the Federal Register publication date, which is set as September 14.
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