By Louise Norris
February 21, 2014
New York State of Health is one of the most successful exchanges in the country, and has been running well since early October. By February 1, total enrollment (including private plans and Medicaid) had grown to 389,435 people. This was an increase of nearly 90,000 in under three weeks, as enrollment had been at about 300,000 on January 12. Of the February 1 total, 211,290 applicants were enrolled in private plans, and 178,145 were enrolled in Medicaid. And in a sign that the NY exchange will continue to thrive, 28% of the private plan enrollees were the coveted “young invincibles” in the 18 – 34 age bracket.
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 have 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:
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.
NY State of Health
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)