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f Health remains strong heading into 2019. The exchange has robust insurer participation, and premiums are still lower for 2019 than they were in 2013. (That’s not the case in most states, but New York had guaranteed-issue coverage long before the ACA, but without a mandate requiring people to buy coverage and without premium subsidies for middle-class enrollees. As a result, coverage was expensive in New York pre-2014.)
Enrollment in NY State of Health – including QHPs (private plans), the Essential Plan, Medicaid, and Child Health Plus – reached more than 4.3 million by the end of January 2018 (when open enrollment ended for QHPs). That was an increase of 700,000 over the prior year’s total enrollment.
New York is a progressive state that embraced health care reform decades ahead of most of the rest of the country. The Affordable Care Act has smoothed out some rough edges in the New York insurance market, and since implementing Obamacare, the state has continued upon these improvements. In January 2017, prior to the inauguration of Donald Trump, New York Governor, Andrew Cuomo, announced that repealing the ACA would cause 2.7 million New Yorkers to lose their health insurance coverage.
Although Republican leaders spent 2017 attempting to repeal the ACA, most of their efforts fell short. All of the ACA repeal bills that were considered in 2017 failed to win enough support to pass, although the GOP tax bill, enacted in December 2017, did repeal the individual mandate penalty, starting in 2019 (there is still a penalty for being uninsured in 2018, which will be assessed on tax returns in early 2019, but there will not be a federal penalty for being uninsured starting in 2019).
A few states have implemented their own individual mandates for 2019 and beyond, although New York is not one of them. But Governor Cuomo took action in early 2017 to protect New York residents’ access to birth control and abortion coverage, regardless of the future of the ACA. The Governor also worked to ensure continued robust insurer participation in the individual market, and ongoing access to essential health benefits. Lawmakers once again considered a single-payer system during the 2018 legislative session — it passed the Assembly, but fell short in the Senate, just as it did in 2017.
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2019 exchange carriers
New York has a very robust individual health insurance
market, with 12 carriers offering plans in the exchange, and two that offer plans only outside the exchange. All of them will continue to offer coverage for 2019, with average rate increases (before subsidies are applied) of 8.6 percent. (Details about approved average rate changes for each plan are available here). The following insurers offer individual-market plans in New York’s exchange:
Capital District Physicians Health Plan
Empire BlueCross and Empire Blue Cross Blue Shield
Excellus (Excellus Blue Cross Blue Shield in Central New York and Univera in Western New York)
Fidelis Care
Health Insurance Plan of Greater New York (EmblemHealth)
Healthfirst New York
HealthNow New York, Inc. (BlueShield of Northeastern New York, and BlueCross BlueShield of Western New York)
Independent Health
MetroPlus Health Plan
MVP Health Plan, Inc.
Oscar Insurance Corporation
United Healthcare of New York, Inc
Two insurers – Crystal Run Health Plan and HealthFirst Insurance Company – will continue to offer off-exchange plans in 2019.
In the small-group market – where more than a million New Yorkers get their health coverage – employers with up to 100 employees can purchase ACA-compliant plans. With the exception of Fidelis, all of the individual-market carriers offer small-group plans, in addition to Aetna Life, Oxford, and some additional divisions of a few of the companies that offer individual market plans.
Fifteen New York health carriers offer plans under the state’s Basic Health Program. Also known as the “Essential Plan,” this coverage is for people with incomes up to 200 percent of the federal poverty level and does not include a deductible or premium. New York and Minnesota are the only states that have established BHPs.
New York State of Health enrollment tops 4.3 million
Open enrollment for 2019 coverage will run from November 1, 2018 to January 31, 2019 for qualified health plans. (Enrollment in Medicaid, Child Health Plus, and the Essential Plan continues year-round.)
Open enrollment for 2018 coverage followed the same November to January schedule, ending on January 31, 2018. In May 2018, New York State of Health published an enrollment report, noting that total enrollment in public and private plans through the exchange (including Medicaid, the Essential Plan, Child Health Plus, and private plans) had reached 4.3 million people by the end of January, which was an increase of 700,000 people compared with the year before.
f Health remains strong heading into 2019. The exchange has robust insurer participation, and premiums are still lower for 2019 than they were in 2013. (That’s not the case in most states, but New York had guaranteed-issue coverage long before the ACA, but without a mandate requiring people to buy coverage and without premium subsidies for middle-class enrollees. As a result, coverage was expensive in New York pre-2014.)
Enrollment in NY State of Health – including QHPs (private plans), the Essential Plan, Medicaid, and Child Health Plus – reached more than 4.3 million by the end of January 2018 (when open enrollment ended for QHPs). That was an increase of 700,000 over the prior year’s total enrollment.
New York is a progressive state that embraced health care reform decades ahead of most of the rest of the country. The Affordable Care Act has smoothed out some rough edges in the New York insurance market, and since implementing Obamacare, the state has continued upon these improvements. In January 2017, prior to the inauguration of Donald Trump, New York Governor, Andrew Cuomo, announced that repealing the ACA would cause 2.7 million New Yorkers to lose their health insurance coverage.
Although Republican leaders spent 2017 attempting to repeal the ACA, most of their efforts fell short. All of the ACA repeal bills that were considered in 2017 failed to win enough support to pass, although the GOP tax bill, enacted in December 2017, did repeal the individual mandate penalty, starting in 2019 (there is still a penalty for being uninsured in 2018, which will be assessed on tax returns in early 2019, but there will not be a federal penalty for being uninsured starting in 2019).
A few states have implemented their own individual mandates for 2019 and beyond, although New York is not one of them. But Governor Cuomo took action in early 2017 to protect New York residents’ access to birth control and abortion coverage, regardless of the future of the ACA. The Governor also worked to ensure continued robust insurer participation in the individual market, and ongoing access to essential health benefits. Lawmakers once again considered a single-payer system during the 2018 legislative session — it passed the Assembly, but fell short in the Senate, just as it did in 2017.
Compare plans and rates in your ZIP code
2019 exchange carriers
New York has a very robust individual health insurance
market, with 12 carriers offering plans in the exchange, and two that offer plans only outside the exchange. All of them will continue to offer coverage for 2019, with average rate increases (before subsidies are applied) of 8.6 percent. (Details about approved average rate changes for each plan are available here). The following insurers offer individual-market plans in New York’s exchange:
Capital District Physicians Health Plan
Empire BlueCross and Empire Blue Cross Blue Shield
Excellus (Excellus Blue Cross Blue Shield in Central New York and Univera in Western New York)
Fidelis Care
Health Insurance Plan of Greater New York (EmblemHealth)
Healthfirst New York
HealthNow New York, Inc. (BlueShield of Northeastern New York, and BlueCross BlueShield of Western New York)
Independent Health
MetroPlus Health Plan
MVP Health Plan, Inc.
Oscar Insurance Corporation
United Healthcare of New York, Inc
Two insurers – Crystal Run Health Plan and HealthFirst Insurance Company – will continue to offer off-exchange plans in 2019.
In the small-group market – where more than a million New Yorkers get their health coverage – employers with up to 100 employees can purchase ACA-compliant plans. With the exception of Fidelis, all of the individual-market carriers offer small-group plans, in addition to Aetna Life, Oxford, and some additional divisions of a few of the companies that offer individual market plans.
Fifteen New York health carriers offer plans under the state’s Basic Health Program. Also known as the “Essential Plan,” this coverage is for people with incomes up to 200 percent of the federal poverty level and does not include a deductible or premium. New York and Minnesota are the only states that have established BHPs.
New York State of Health enrollment tops 4.3 million
Open enrollment for 2019 coverage will run from November 1, 2018 to January 31, 2019 for qualified health plans. (Enrollment in Medicaid, Child Health Plus, and the Essential Plan continues year-round.)
Open enrollment for 2018 coverage followed the same November to January schedule, ending on January 31, 2018. In May 2018, New York State of Health published an enrollment report, noting that total enrollment in public and private plans through the exchange (including Medicaid, the Essential Plan, Child Health Plus, and private plans) had reached 4.3 million people by the end of January, which was an increase of 700,000 people compared with the year before.