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42 U.S. Code § 18051. State flexibility to establish basic health programs for low-income individuals not eligible for medicaid
(a) Establishment of program
(1) In general
The Secretary shall establish a basic health program meeting the requirements of this section under which a State may enter into contracts to offer 1 or more standard health plans providing at least the essential health benefits described in section 18022(b) of this title to eligible individuals in lieu of offering such individuals coverage through an Exchange.
(2) Certifications as to benefit coverage and costsSuch program shall provide that a State may not establish a basic health program under this section unless the State establishes to the satisfaction of the Secretary, and the Secretary certifies, that—
(A) in the case of an eligible individual enrolled in a standard health plan offered through the program, the State provides—
(i)
that the amount of the monthly premium an eligible individual is required to pay for coverage under the standard health plan for the individual and the individual’s dependents does not exceed the amount of the monthly premium that the eligible individual would have been required to pay (in the rating area in which the individual resides) if the individual had enrolled in the applicable second lowest cost silver plan (as defined in section 36B(b)(3)(B) of title 26) offered to the individual through an Exchange; and
(ii) that the cost-sharing an eligible individual is required to pay under the standard health plan does not exceed—
(I)
the cost-sharing required under a platinum plan in the case of an eligible individual with household income not in excess of 150 percent of the poverty line for the size of the family involved; and
(II)
the cost-sharing required under a gold plan in the case of an eligible individual not described in subclause (I); and
(B)
the benefits provided under the standard health plans offered through the program cover at least the essential health benefits described in section 18022(b) of this title.
For purposes of subparagraph (A)(i), the amount of the monthly premium an individual is required to pay under either the standard health plan or the applicable second lowest cost silver plan shall be determined after reduction for any premium tax credits and cost-sharing reductions allowable with respect to either plan.