screen-shot-2016-08-26-at-4-50-02-pm-300x220-8940600Sign-ups for both government-sponsored and private health coverage through the New York State of Health insurance exchange surged during this year’s open-enrollment period, a sign of continued consumer demand in the face of political turmoil and rising premiums.

Perhaps most surprising was the 4 percent jump in sign-ups for commercial insurance plans offered through the exchange, which came in spite of premium hikes averaging 14.5 percent. Most enrollees in these plans, known as Qualified Health Plans, qualify for tax credits that reduce their net cost, but the exchange said that 41 percent are paying full price.

Even with the uptick—the first in three years—enrollment in New York’s private exchange plans remains relatively low, largely because of competition from the low-cost, government-sponsored Essential Plan that launched in 2016.

screen-shot-2018-02-02-at-11-52-40-am-1041662

Indeed, Essential Plan enrollment grew by 74,000, or 11 percent, compared to this time last year. Although the plan allows year-round sign-ups, about half of that growth came during the open-enrollment period that ran from November through January.

The Essential Plan is an optional benefit under the Affordable Care Act that only New York and Minnesota chose to implement. New York’s version is available to adults between 138 percent and 200 percent of the federal poverty level, and costs either $0 or $20 a month.

The federal government had been covering 95 percent of the plan’s cost. However, the Trump administration recently halted payment of a quarter of that aid, or about $1 billion a year, citing a court ruling that the funding had not been properly appropriated by Congress.

Although rapidly growing enrollment would seem to widen a hole in the program’s funding, the impact on state finances is unclear. Governor Andrew Cuomo’s proposed budget for 2018-19 acknowledges that federal funding for the program is in jeopardy and mentions strategies for closing the gap. But its numbers show the federal contribution continuing at the previous level. And its enrollment forecasts are about 50,000 lower than what was just reported by the exchange.

Also seeing rapid growth is Child Health Plus (CHP), which jumped by 75,000, or 25 percent. CHP is available to children under 19 and charges premiums on a sliding scale based on family income. With last month’s vote to extend the program for six years, New York will continue receiving federal aid to cover 88 percent of the cost.

Officials further reported that Medicaid enrollment through the exchange increased by almost 540,000, or 22 percent. However, overall Medicaid enrollment—both on and off the exchange—has been virtually flat at 6.1 million for the past two years.

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

The Wacky Math of New York’s Essential Plan

Thanks to an absurdly wasteful federal law, New York's Essential Plan is expected to continue running billion-dollar surpluses even as state officials more than double its spending over the next several years. Read More

In a Tight Budget Year, New York’s Hospital Lobby Shoots for the Moon

As Governor Hochul calls for spending restraint next year, influential hospital lobbyists are pushing what could be the costliest budget request ever floated in Albany. In a , the G Read More

Putting the Mission in Hochul’s Health Commission

Last week Governor Hochul answered one big question about her Commission on the Future of Health Care – the names of its members – but left a fundamental mystery unresolved:  W Read More

Medicaid Drug ‘Carve-Out’ Led to Double Payments

The state's Medicaid program has effectively been double-paying for prescription drugs for the past six months due to a glitch with the roll-out of its pharmacy "carve-out." Since A Read More

DFS Pulls Back Draft Regulations That Would Have Added a Fee for Prescriptions

A package of proposed regulations that included a $10.18 fee for filling most drug prescriptions was withdrawn Tuesday by the Department of Financial Services in the face of broad opposition. Read More

Hochul’s Promised Health Care Commission Has Yet To Be Appointed

A health-care commission that is supposed to be helping the state control soaring Medicaid costs – which Governor Hochul promised in January and described as "under way" last month – appears not to exist. Thre Read More

New York’s Medicaid Spending Is Running Billions Over Budget

New York's Medicaid program ran billions of dollars over budget during the first half of the fiscal year, adding to signs of a brewing fiscal crisis in Albany. According to the fro Read More

State Regulators Propose a $10 Fee for Filling Prescriptions

The Hochul administration is proposing to mandate a $10.18 "dispensing fee" for almost every prescription filled in New York, a change that would add billions of dollars to health-care costs statewide. Read More

Empire Center Logo Enjoying our work? Sign up for email alerts on our latest news and research.
Together, we can make New York a better place to live and work!