As I wrote about back in March and updated in May, New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.
New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over eleven times as many people as Minnesota's "MinnesotaCare" program does (around 1.1 million vs. 100K). Part of this is obviously due to New York having a larger population, but that's only part of it (NY has 19.84M residents, just 3.5x higher than MN's 5.71M).
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
NEW YORK – New York Attorney General Letitia James and Acting Department of Health (DOH) Commissioner Dr. James McDonald today warned New Yorkers about a new scam targeting New Yorkers enrolled in public health insurance programs and provided important tips to protect consumers. For the first time since March 2020, people enrolled in Medicaid, Child Health Plus and the Essential Plan will have to renew their health insurance coverage. Attorney General James and Acting Commissioner Dr. McDonald are urging New Yorkers to be vigilant in light of reports of scammers deceptively calling people and asking them to pay hundreds of dollars to maintain their health insurance.
“It is despicable that scammers are trying to exploit New Yorkers’ need for quality health insurance and uncertainty over ongoing Medicaid coverage,” said Attorney General James. “The best tool consumers and families have to combat scams is knowledge, and that is why I am committed to raising this issue. I urge everyone to follow our important tips, and anyone impacted by this scam to contact my office immediately.”
Since March 2020, Aligned with Federal Continuous Coverage Requirements, Enrollment in NY State of Health Programs has Grown by 41 Percent
As the Post-Public Health Emergency Redetermination Process Begins, State Has Deployed Multi-pronged Strategy to Maximize Number of Consumers who Maintain Coverage
ALBANY, N.Y. (April 20, 2023) – NY State of Health, the state’s official health plan Marketplace, today released the 2023 Health Insurance Coverage Update, a detailed summary of NY State of Health enrollment, including demographics, quality measures, and the cost savings realized by millions of New Yorkers who have comprehensive health insurance through the Marketplace. As of January 31, 2023, NY State of Health enrollment is nearly 6.9 million, or more than one in three New Yorkers across the state.
In my post a few weeks ago about Minnesota's plan to dramatically expand their existing Basic Health Plan (BHP) program, MinnesotaCare, into a full-fledged Public Option open to residents not currently eligible for the program, I made an offhand reference to similar BHP expansion-related news happening in New York State. However, I haven't gotten around to actually writing about NY's BHP program until now.
New York's implementation of the ACA's BHP provision (Section 1331 of the law) is called the Essential Plan, and it already serves over eleven times as many people as Minnesota's does (around 1.1 million vs. 100K). Part of this is obviously due to New York having a larger population, but that's only part of it (NY has 19.84M residents, just 3.5x higher than MN's 5.71M).
Back in May, I first wrote about news that two additional states, Oregon and Kentucky, had decided to join New York and Minnesota in launching a Basic Health Plan (BHP) program under a provision allowing them to do so in the Affordable Care Act:
The Basic Health Program (BHP) – section 1331 of the ACA — was envisioned as a solution, although most states did not establish a BHP. Under the ACA (aka Obamacare), states have the option to create a Basic Health Program for people with incomes a little above the upper limit for Medicaid eligibility, and for legal immigrants who aren’t eligible for Medicaid because of the five-year waiting period.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
Biden-Harris Administration Extends Hundreds of Millions of Dollars to New York’s Essential Plan, its Basic Health Program, Key Connection to Coverage Supported by American Rescue Plan
The Centers for Medicare & Medicaid Services (CMS) is providing approximately $750 million in additional funding in 2022 to support the Essential Plan, New York’s Basic Health Program (BHP), as well as added funds for 2020 and 2021. The additional funds, made available through the American Rescue Plan, increase New York’s ability to provide health care coverage to approximately 1 million individuals.
Biden-Harris Administration Extends Millions in Funding to Minnesota for MinnesotaCare, its Basic Health Program, Key Connection to Coverage Supported by American Rescue Plan
The Centers for Medicare & Medicaid Services (CMS) is providing approximately $100 million in additional funding in 2022 to support MinnesotaCare, Minnesota’s Basic Health Program (BHP), as well as added funds for 2020 and 2021. The additional funds, made available through the American Rescue Plan, increase Minnesota’s ability to provide affordable, quality health care coverage to approximately 100,000 individuals.
