Quick Answer: The Basic Health Program (BHP) is an ACA option that lets states offer subsidized health coverage to adults earning between 138% and 200% of the federal poverty level (FPL). As of 2026, four jurisdictions run a BHP: Minnesota (MinnesotaCare), Oregon (OHP Bridge), Washington DC (Healthy DC Plan), and New York (Essential Plan, returning to BHP authority in July 2026). Most BHP plans charge no monthly premiums and have little to no cost-sharing.
The Basic Health Program fills a coverage gap that exists in every state but that only a handful have chosen to close. Under the ACA, once your income rises above the Medicaid cutoff (roughly 138% FPL in expansion states), you normally have to shop for a marketplace plan. For many people in that 138%-to-200%-FPL range, marketplace premiums still feel out of reach even with subsidies. The BHP was designed to solve exactly that problem.
Created under Section 1331 of the ACA, the BHP lets states receive federal funding to operate their own low-cost health coverage program for residents whose income sits in that gap. In practice, BHP plans look and feel like Medicaid: no premiums in most cases, low or no cost-sharing, and the same network of providers. But they are distinct legal programs, and eligibility rules vary by state.
If you live in New York, Minnesota, Oregon, or Washington DC and earn somewhere between the Medicaid cutoff and $31,920 per year as a single person (200% FPL in 2026), this guide explains who qualifies, what you get, and how to enroll. You can also check your eligibility in two minutes at CoveredUSA.
What Is the Basic Health Program?
The BHP is a federal-state partnership authorized by the ACA at CMS.gov. States that adopt it receive a federal funding allotment, roughly 95% of what the federal government would have paid in premium tax credits and cost-sharing reductions for those enrollees on the marketplace. States then use that money to offer coverage at lower cost than the marketplace would charge.
Key federal eligibility rules that every BHP must follow:
- Adults ages 19 to 64 (not eligible for Medicare)
- Income between 133% and 200% FPL (some states use the 138% Medicaid expansion cutoff as the floor)
- Not eligible for Medicaid, CHIP, or affordable employer-sponsored coverage
- Must be a U.S. citizen or a lawfully present non-citizen
Beyond those federal minimums, states set their own plan designs, networks, and cost-sharing rules. That is why MinnesotaCare looks different from Oregon's OHP Bridge.
2026 BHP Income Limits by Household Size
The table below shows the 2026 income range that qualifies for the BHP in the 48 contiguous states and DC (based on 2026 federal poverty guidelines from ASPE/HHS). Your income must fall above the Medicaid cutoff (138% FPL) and at or below 200% FPL to qualify.
2026 BHP Income Eligibility Range: 48 Contiguous States and DC
| Household Size | 138% FPL (Medicaid Cutoff) | 200% FPL (BHP Upper Limit) |
|---|
| 1 | $22,025/year | $31,920/year |
| 2 | $29,863/year | $43,280/year |
| 3 | $37,702/year | $54,640/year |
| 4 | $45,540/year | $66,000/year |
| 5 | $53,378/year | $77,360/year |
| 6 | $61,217/year | $88,720/year |
| 7 | $69,055/year | $100,080/year |
| 8 | $76,893/year | $111,440/year |
| Each additional person | +$7,838 | +$11,360 |
If your income falls below 138% FPL in an expansion state, you qualify for Medicaid, not the BHP. If it falls above 200% FPL, you would shop for a marketplace plan at healthcare.gov.
Minnesota: MinnesotaCare
MinnesotaCare is the oldest BHP in the country, launched on January 1, 2015. It is Minnesota's Basic Health Program and it covers adults between 138% and 200% FPL who do not have access to affordable employer coverage. Minnesota is one of a small number of states that has operated a BHP continuously since the ACA gave states the option.
Who qualifies for MinnesotaCare in 2026:
- Age 19 to 64
- Minnesota resident
- Income between 138% and 200% FPL (up to $31,920 for a single person or $66,000 for a family of four in 2026)
- No access to affordable employer coverage
- Not eligible for Medical Assistance (Minnesota Medicaid) or Medicare
- U.S. citizen or eligible non-citizen
What it covers: MinnesotaCare provides comprehensive coverage including doctor visits, hospital care, mental health and substance use treatment, dental, vision, and prescription drugs. Premiums are low, typically a few dollars per month for lower-income enrollees, with a cap based on a percentage of income. The state publishes its premium schedule on MNsure.org.
How to apply: Minnesotans apply through MNsure (the state marketplace) at MNsure.org or by calling 855-366-7873. MinnesotaCare is open for enrollment year-round because it is not subject to marketplace open enrollment windows.
Oregon: OHP Bridge
Oregon launched its BHP on July 1, 2024, naming it OHP Bridge (the Oregon Health Plan Bridge program). It covers adults in the income gap between regular OHP (Oregon Medicaid) and marketplace plans.
Who qualifies for OHP Bridge in 2026:
- Age 19 to 64
- Oregon resident
- Income between 138% and 200% FPL
- Not eligible for OHP (Oregon Medicaid), Medicare, or other minimum essential coverage
- No access to affordable employer-sponsored insurance
- Eligible citizenship or immigration status
What it covers: OHP Bridge covers medical, dental, and behavioral health care. According to the Oregon Health Authority, the program charges no premiums, no copayments, no coinsurance, and no deductibles. That makes it effectively free for members who qualify.
How to apply: Apply online at ONE.Oregon.gov, by phone at 1-800-699-9075 (TTY 711), or by calling OregonHealthCare.gov at 855-268-3767. Like MinnesotaCare, OHP Bridge accepts applications year-round.
Washington DC: Healthy DC Plan
DC's Healthy DC Plan is the newest BHP, effective January 1, 2026. Before 2026, DC provided Medicaid to residents up to 215% FPL, one of the most expansive Medicaid programs in the country. Federal law changes in 2025 made that financially unsustainable, so DC restructured its coverage and launched the Healthy DC Plan as a BHP to preserve access for the income band between 138% and 200% FPL.
Who qualifies for the Healthy DC Plan in 2026:
- Age 19 to 64
- DC resident
- Income between 138% and 200% FPL (approximately $22,025 to $31,920 for a single person)
- Not eligible for DC Medicaid, Medicare, or affordable employer coverage
- U.S. citizen or lawfully present non-citizen (including those subject to the five-year Medicaid bar)
What it covers: The Healthy DC Plan covers the same comprehensive benefit package DC residents expect from Medicaid-equivalent coverage. Premiums are $0, and cost-sharing is minimal to none. Details are available at DC Health Link.
How to apply: Apply through DC Health Link at DCHealthLink.com or call 855-532-5465. DC Health Link is the city's official marketplace and BHP enrollment portal.
New York: Essential Plan (Returning to BHP in July 2026)
New York's Essential Plan has a complicated history. It launched in 2015 as a BHP, was later converted to a Section 1332 waiver structure that allowed coverage up to 250% FPL, and is now returning to BHP authority as of July 1, 2026.
The shift matters for current Essential Plan enrollees. Starting July 1, 2026, the income cap drops from 250% FPL back to 200% FPL. New Yorkers between 200% and 250% FPL will lose Essential Plan eligibility and will need to transition to a marketplace plan. Roughly 1.3 million New Yorkers with incomes below 200% FPL retain coverage through the Essential Plan under its new BHP structure.
Who qualifies for the Essential Plan in 2026 (after July 1):
- Age 19 to 64
- New York resident
- Income between 138% and 200% FPL (up to $31,920 for a single person in 2026)
- Not eligible for Medicaid, Medicare, or affordable employer coverage
- U.S. citizen or eligible non-citizen; also covers certain immigrants ineligible for Medicaid
What it covers: The Essential Plan covers preventive care, doctor visits, hospitalizations, mental health services, dental, vision, and prescriptions. Most Essential Plan enrollees pay no premium or a very small one. Copays are low.
How to apply: Apply through NY State of Health at NYStateofHealth.ny.gov or call 855-355-5777. Enrollment is open year-round. New Yorkers who were on the expanded Essential Plan (200%-250% FPL) should contact NY State of Health to understand their options before the July 1 cutoff.
How to Apply for BHP Coverage: Step-by-Step
The application process is similar across all four BHP states, though each uses its own portal.
- Check your income. Use the 2026 BHP income table above to confirm you fall between 138% and 200% FPL for your household size.
- Confirm you are not already eligible for Medicaid or Medicare. If you earn less than 138% FPL, apply for Medicaid instead. If you are 65 or older, apply for Medicare.
- Go to the correct portal for your state:
- Minnesota: MNsure.org
- Oregon: ONE.Oregon.gov
- Washington DC: DCHealthLink.com
- New York: NYStateofHealth.ny.gov
- Create an account (or log in if you have one) and start a new application.
- Enter household and income information. The portal will determine whether you qualify for Medicaid, BHP, or a marketplace plan.
- Select a plan from the options shown. BHP plans are often pre-selected or presented with a clear recommendation for your income level.
- Submit the application and follow any instructions to verify your documents.
Documents you will typically need:
- Proof of identity (driver's license, passport, or state ID)
- Proof of residency (utility bill, lease, bank statement)
- Proof of income (recent pay stubs, tax returns, or employer letter)
- Immigration documents (if applicable)
- Social Security number (if you have one)
Common reasons BHP applications get denied:
- Income is below 138% FPL (Medicaid applies instead)
- Income exceeds 200% FPL (marketplace plans apply instead)
- Eligible for affordable employer-sponsored coverage
- Already enrolled in Medicare
- Residency not verified for the state
BHP vs. Marketplace Plans: What Is the Difference?
If you earn between 138% and 200% FPL, you technically have two choices: the BHP (if your state has one) or a subsidized marketplace plan. This comparison shows why most people choose the BHP.
2026 Coverage Comparison for Adults at 150%-200% FPL
| Feature | BHP (NY, MN, OR, DC) | ACA Marketplace Plan |
|---|
| Monthly premium | $0 to very low | Low with subsidies; varies by plan |
| Deductible | $0 in most BHP states | Often $0 to $1,000 for silver plans |
| Copays | $0 to minimal | $15 to $45 per visit |
| Dental coverage | Included (varies by state) | Usually separate/not included |
| Vision coverage | Included (varies by state) | Usually separate/not included |
| Behavioral health | Included | Included |
| Annual enrollment | Year-round | Open enrollment only (Nov-Jan) |
For most people in BHP states, the BHP is the better financial deal. The main exception: if you earn slightly above 200% FPL, you cannot access the BHP and should compare marketplace silver plans, which still come with strong subsidies at that income level under current law.
How to Apply
Enrollment timing: BHP programs in all four jurisdictions accept applications year-round. There is no open enrollment window. If you qualify at any point in the year, you can apply and get coverage.
Official enrollment portals by state:
Check your eligibility now at CoveredUSA. It takes 2 minutes. The free screener at coveredusa.org/screener asks about your state, household size, and income, and tells you whether you likely qualify for Medicaid, a BHP, or a marketplace plan.
Frequently Asked Questions
What is the Basic Health Program (BHP)?
The Basic Health Program is an optional ACA provision (Section 1331) that allows states to create subsidized health coverage for adults earning between 133% and 200% of the federal poverty level who do not qualify for Medicaid or affordable employer coverage. As of 2026, Minnesota, Oregon, Washington DC, and New York operate BHPs.
Which states have a Basic Health Program in 2026?
Four jurisdictions have an active BHP in 2026: Minnesota (MinnesotaCare), Oregon (OHP Bridge), Washington DC (Healthy DC Plan), and New York (Essential Plan, returning to BHP authority on July 1, 2026). No other states currently operate a BHP, though the Urban Institute and others have studied the option for several additional states.
How much does BHP coverage cost?
Most BHP plans charge no monthly premium for enrollees near the lower end of the income range. Copays and cost-sharing are typically minimal or zero. MinnesotaCare charges small income-based premiums; Oregon's OHP Bridge and DC's Healthy DC Plan are both free. New York's Essential Plan charges no premium for most enrollees.
What income qualifies for the BHP in 2026?
In 2026, you need household income between 138% and 200% FPL. For a single person, that range is roughly $22,025 to $31,920 per year. For a family of four, that is roughly $45,540 to $66,000 per year, based on 2026 FPL guidelines from ASPE/HHS.
Can immigrants qualify for the BHP?
Yes, in many cases. Lawfully present non-citizens can qualify for the BHP even if they are ineligible for Medicaid due to the five-year waiting period. DC's Healthy DC Plan specifically highlights coverage for immigrants subject to the five-year Medicaid bar. Eligibility depends on immigration status and state-specific rules.
Does the BHP count as minimum essential coverage?
Yes. BHP plans satisfy the ACA's minimum essential coverage requirement. Enrollees are not subject to any tax penalty (the federal individual mandate penalty is $0 but some states like New Jersey and California still have state-level requirements).
What happens if my income goes above 200% FPL?
If your income rises above 200% FPL, you are no longer eligible for the BHP. You would transition to a marketplace plan. Most BHP states have a special enrollment period for people who lose BHP eligibility, so you can move to marketplace coverage without waiting for open enrollment.
Will the BHP survive proposed federal cuts in 2026?
Pending federal legislation (the "One Big Beautiful Bill" as of mid-2026) includes provisions that could restrict BHP funding and eligibility for certain immigrants. New York has already adjusted its Essential Plan in response to earlier federal changes. Check healthcare.gov or your state's enrollment portal for the most current guidance, as federal policy in this area is actively changing.
I am not in NY, MN, OR, or DC. What are my options?
If you live in a Medicaid expansion state and earn less than 138% FPL, you qualify for Medicaid. If you earn between 138% and 400% FPL, you likely qualify for a subsidized ACA marketplace plan. Use the CoveredUSA screener at coveredusa.org/screener to see what you qualify for based on your state and income. You can also check ACA income limits at coveredusa.org/aca-income-limits for a full breakdown by state.
