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New York health insurance exchange

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An exchange success story: New York State of Health total enrollment exceeds 812,000

By
March 31, 2014

Open enrollment in New York ends on March 31.  But the state-run exchange is allowing an extension until April 15 for applicants who begin the process by that date, but are unable to complete their enrollment by the end of the day on March 31.

New York State of Health is one of the most successful exchanges in the country, and has been running well since early October.  By March 27, total enrollment (including private plans and Medicaid) had grown to 782,000 people (including 367,000 private plan enrollees and 415,000 Medicaid enrollees).  The total swelled to 812,000 by early in the day on March 31 (total not yet broken down by QHP and Medicaid counts), and the exchange was reporting total enrollment of more than 100,000 people in the last week of March.  Among all enrollees, roughly 70% were uninsured prior to enrolling in coverage, so NY is certainly making a huge dent in its uninsured population.

New York Governor Andrew Cuomo included the ACA’s Basic Health Program in his budget proposal released in late January.  If approved by the NY legislature, the BHP could be providing health insurance for people with incomes between 133% and 200% of poverty by 2016.  Although provisions for the BHP were included in the ACA, only a handful of states have thus far expressed interested in pursuing the BHP as a way to provide health insurance for low income residents who don’t qualify for Medicaid.  That NY is among them is no surprise, given how dedicated the state has been to implementing and supporting the ACA.

Given the success of the exchange, officials in New York declined President Obama’s offer to allow health insurance plans scheduled for year-end termination to be extended into 2014.  Roughly 100,000 NY residents received cancellation notices, but that figure is dwarfed by the number of people who enrolled in exchange plans with January 1 effective dates, so it’s likely that most of the cancelled plans were replaced with new ACA-compliant plans.

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.

Gov.  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)

As of February 20, Metro Plus was reporting that it had enrolled 32,000 people in its NY exchange plans, and half of them are under age 35.

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
855-355-5777

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)

Health Insurance Exchange – Federal Health Care Reform Implementation in New York State

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New York Governor Andrew Cuomo
State Capitol
Albany, NY 12224
PHONE: 518-474-8390
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