New York health insurance exchange
An exchange success story: New York State of Health
By Louise Norris
November 21, 2013
New York State of Health is one of the most successful exchanges in the country, and has been running well since early October. By mid-November, more than 48,000 people had enrolled and completed their applications, with roughly half qualifying for Medicaid and half purchasing private insurance. New York’s exchange enrollment is second only to California, and nearly 200,000 additional NY residents have applied but have not yet selected their plans.
Given the success of the exchange, officials in New York have declined President Obama’s offer to allow health insurance plans scheduled for year-end termination to be extended into 2014. More than 100,000 New York residents with individual health insurance have received policy cancellation notices, but as long as they select a New York State of Health plan by December 15th, they will have no gap in coverage.
New York launched its consumer-facing website for its health insurance marketplace, NY State of Mind, on Aug. 20. The website included FAQs, an interactive map showing which health plans are available by county, and a calculator to help consumers learn if they are eligible for tax credits and how much they will pay for health insurance.
New York Gov. Andrew Cuomo established New York’s marketplace, or health insurance exchange, through an executive order. Cuomo issued the order in April 2012 after New York’s legislature failed to approve an exchange law in both the 2011 and 2012 sessions.
Cuomo cited numerous reasons in his executive order for starting an exchange. According to the governor’s office, state and local governments pay more than $600 million every year to cover the health care costs of uninsured individuals. Uninsured individuals, the order read, “frequently forego preventive care and other needed treatment, putting them at risk of being sicker throughout their lives and dying sooner than those who have health insurance, which diverts funds from other public uses …”
New York enacted ACA-style reforms in the individual market two decades ago; policies there have been guaranteed issue and community rated ever since. This meant that premiums in New York were far higher than in other states where medical underwriting was utilized. There was no individual mandate, and few insurers participated in the pre-ACA individual market in New York. The ACA’s individual mandate has increased the number of carriers offering policies in New York, and premiums in 2014 will be lower than they were in 2013. Combined with the ACA’s premium subsidies, these changes make individual health insurance far more affordable in New York than it used to be.
Sixteen insurers – double the national average – are participating in the state’s marketplace:
- Affinity Health Plan, Inc.
- American Progressive Life & Health Insurance Company of New York (Today’s Options of NY, Inc.)
- Capital District Physicians Health Plan, Inc.
- Health Insurance Plan of Greater New York (EmblemHealth)
- Empire BlueCross and Empire Blue Cross Blue Shield
- Excellus (Excellus Blue Cross Blue Shield in Central NY and Univera in Western NY)
- Fidelis Care
- Freelancers Co-Op (Health Republic Insurance)
- Healthfirst New York
- HealthNow New York, Inc. (Blue Shield of NENY; Blue Cross Blue Shield of Western NY)
- Independent Health
- MetroPlus Health Plan (Market Plus)
- MVP Health Plan, Inc.
- North Shore LIJ
- Oscar Insurance Corporation
- United Healthcare of New York, Inc. (United, Oxford)
Aetna had originally planned to sell policies in the New York exchange, but pulled out in late August.
About 2.7 million people in New York — about 16 percent of the population — do not have health insurance, according to the Urban Institute. About 1.1 million are expected to buy insurance through the new marketplace.
Contact the New York exchange
NY State of Health
More New York health insurance exchange links
State Exchange Profile: New York
The Henry J. Kaiser Family Foundation overview of New York’s progress toward creating a state health insurance exchange.
Health Care For All New York (HCFANY)