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.
2023-24 Enacted Budget Invests in Health Equity by Adopting Key Evidence-Based Interventions to Better Care for New York Parents and Newborns
ALBANY, N.Y. (August 24, 2023) – The New York State Department of Health announced several key initiatives aimed at improving maternal and newborn health. Enacted as part of the 2023-24 New York State Budget, the state is committing to multiple Medicaid investments that will expand access to prenatal and postnatal care and support better birth outcomes. This announcement is released on the heels of the State’s adoption of the federal option to extend Medicaid and Child Health Plus (CHPlus) postpartum coverage from 60 days to a full year following pregnancy.
Nearly Three Quarters of New Yorkers Enrolled in Medicaid, Child Health Plus or the Essential Plan Have Renewed Their Coverage by the June Deadline; Renewal Strategies Are Working; Others Still Have Time to Act
New York Outperforming National Average as Reported by KFF
Monthly Dashboard Tracks Renewal Status, Demographics, and State Program Transitions During Public Health Emergency Unwind
ALBANY, N.Y. (July 18, 2023) – The New York State Department of Health today released the first issue of New York’s Public Health Emergency Unwind Dashboard, a monthly report reflecting data on renewal status, demographics, and program transitions for public health insurance enrollees, which shows renewal outreach strategies are working. The report indicates that roughly 72 percent of New Yorkers enrolled in Medicaid, Child Health Plus or the Essential Plan renewed their coverage before the June deadline to re-enroll and those who haven’t still have time to act to avoid potential lapses in coverage. As reported by KFF, the national renewal rate for states reporting data is 59 percent.
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.
Governor Kathy Hochul today encouraged eligible New Yorkers to renew their health insurance coverage as insurance renewal deadlines rapidly approach. The Governor also issued a public service announcement to get the message out to New Yorkers.
Thanks to the Biden-Harris Administration’s efforts to strengthen maternal health, an estimated 509,000 Americans annually are now eligible for essential care for a full year after pregnancy.
Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced New York’s extension of comprehensive coverage after pregnancy through Medicaid and the Children’s Health Insurance Program (CHIP) for postpartum individuals for a full 12 months.
Ouch. Via the New York Dept. of Financial Services, the preliminary, weighted average rate increases being requested for individual market health insurance policies for 2024 are looking pretty ugly indeed: 20.9% overall according to DIFS. I get a slightly lower weighted average of 20.7%, but it still ain't pretty.
Two of the highest increases are for carriers which are only offering policies off-exchange next year and which have fewer than 100 enrollees each anyway; I assume they're both winding down their operations in the state. There are also two carriers which appear to be leaving the NY individual market entirely this year.
As for the rest, they range from requested average increases of "only" 13.3% for MVP to a stunning 52.7% rate hike by Emblem (HIP). The justification summaries are below the table.
It's important to remember that these are not final rate increases--New York in particular has a tendency to slash the requested rate hikes down significantly before approving them:
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.”
Enrollment Assistors Attend YMCA Kids Day Events Throughout the State to Help Consumers Renew or Enroll in Health Coverage
Eligibility Redeterminations will be Resuming for Over 9 Million New Yorkers in Medicaid, Child Health Plus and the Essential Plan
ALBANY, N.Y. (April 27, 2023) – NY State of Health, the state’s official health plan Marketplace, today announced it will participate in the YMCA’s annual Healthy Kids Day, a national initiative featuring free community events with family-friendly activities that promote wellness. Certified enrollment assistors will be available at select YMCAs statewide on April 29, 2023, to provide free help to New Yorkers. They will provide information about upcoming changes to their health insurance, answer questions about renewals, and provide information to uninsured New Yorkers about enrolling in coverage through the Marketplace.