Governor Kathy Hochul today was joined by the Democratic Leader of the U.S. House of Representatives Congressman Hakeem Jeffries and leaders in the health care and labor sectors to sound the alarm on the detrimental effects of several healthcare provisions already passed by the House of Representatives in the Republican budget reconciliation bill. These provisions collectively amount to an annual loss of nearly $13.5 billion for New Yorkers and our healthcare sector, jeopardizing healthcare access for millions of New Yorkers and threatening the state’s hospitals and healthcare providers.
“Republicans in Washington have made it abundantly clear that they are determined to dismantle the social safety net that millions of New Yorkers rely on to secure their basic necessities,” Governor Hochul said. “They are specifically targeting essential and life-saving programs such as Medicaid and food stamps with the consequence that everyday Americans will bear the brunt of this attack. I am committed to utilizing litigation and other appropriate tools to safeguard and protect New Yorkers.”
Estimated Nearly $13.5 Billion Loss Annually For New Yorkers and Our Healthcare Economy
Nearly 1.5 Million New Yorkers Could Lose Essential Plan or Medicaid Coverage And Become Uninsured
Governor Hochul Demands Republican Members of Congress Oppose These Cuts and Protect Their Constituents
Governor Kathy Hochul today updated New Yorkers on the harmful effects of several healthcare provisions already passed from the House Ways & Means and Energy & Commerce committees for the Republican budget reconciliation bill. These provisions collectively amount to an annual loss of nearly $13.5 billion for New Yorkers and our healthcare sector, jeopardizing healthcare access for millions of New Yorkers while imperiling the state’s hospitals and other healthcare providers.
December 15 Deadline Approaches for Enrollment in Health Coverage Beginning January 1, 2025 Through NY State of Health
New Cost Savings and Expanded Eligibility in the Essential Plan and Qualified Health Plans Make Insurance More Affordable for More New Yorkers
ALBANY, N.Y. (December 13, 2024) — The State Department of Health’s NY State of Health, the State’s official health plan Marketplace, reminds New Yorkers that December 15 is the last day to enroll in health coverage beginning January 1, 2025. This year brings unprecedented cost savings in the Essential Plan and Qualified Health Plans, which offer dramatically reduced out-of-pocket costs.
First, they went live on April 1st with expanding their wildly popular Basic Health Plan program (called the Essential Plan), which was already providing comprehensive, affordable healthcare coverage to 1.4 million New Yorkers, up the income scale from maxing out at 200% of the Federal Poverty Level up to 250% FPL. This increased enrollment in the program to 1.5 million people.
As I've written about several times before, starting April 1st, New York State expanded their wildly popular Essential Plan program (NY's name for the ACA's Basic Health Plan program) up the household income scale from 200% of the federal poverty level (FPL) to 250% FPL:
On March 1, 2024, the U.S. Department of Health and Human Services (HHS) and U.S. Department of Treasury approved New York's Section 1332 State Innovation Waiver application to expand the Essential Plan. Section 1332 State Innovation Waivers allow states to pursue innovative strategies for providing residents with access to high quality, affordable health insurance. The waiver was approved for five years, from 2024 through 2028.
...Key Components of the Waiver
This approved State Innovation waiver expands health insurance and covers health-related social needs, improving health care and advancing health equity. The waiver includes the following key components:
Earlier today I noted that New York has officially implemented their expansion of the Essential Plan, their branding of the ACA-funded Basic Health Plan (BHP) program that currently covers 1.2 million New Yorkers, from residents earning under 200% of the Federal Poverty Level up to those earning as much as 250% FPL.
In doing so, around 100,000 additional people are now enrolled in the BHP program, with roughly 62,000 of them now saving an average $4,700/year versus the ACA exchange plans they were previously enrolled in, plus another ~32,000 who I presume are completely new to either program.
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 1.2 million New Yorkers, or over 4x 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.
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 1.2 million New Yorkers, or over 4x 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.
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 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.
