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Medicaid drove NY State of Health exchange enrollment to double in 2015

Enrollment in New York’s health insurance exchange more than doubled between 2014 and 2015, across the state and in Western New York, driven by soaring enrollment in Medicaid, the state Health Department reported Wednesday.

About 2.1 million New Yorkers were enrolled in coverage through the NY State of Health marketplace at the end of February, a sharp increase from the 961,000 enrolled at the end of the 2014 period, with 80 percent of them enrolled in Medicaid or Child Health Plus, according to the department’s first detailed breakdown of exchange enrollment through the end of the 2015 sign-up period. In the eight counties of Western New York, enrollment more than doubled from 55,844 to 117,330 between last year and this year.

With 415,000 people enrolled in a private insurance plan, state health officials said the exchange remains on track to meet projections of enrolling 615,000 in private plans by the end of 2016. Seventy-four percent of those enrolled in a private insurance plan were eligible for a financial subsidy meant to bring down the cost of their insurance, and the average tax credit they received was $220 per month.

The marketplace opened Oct. 1, 2013, and 960,762 people were enrolled in coverage when the first sign-up period ended April 15, 2014. The second enrollment period ran from Nov. 15 to Feb. 28.

The exchange is a key piece of the federal Affordable Care Act. The measure sought to cover the uninsured, while lowering overall health care spending, but it has generated controversy.

Highlights from the report include:

• The state sent renewal notices to the more than 300,000 people enrolled in a private health plan at the end of the 2014 sign-up period, and 86 percent of them renewed their coverage for 2015.

• The nearly 1.6 million people enrolled in Medicaid make up 73 percent of total exchange enrollment, a sharp increase from the 55 percent of total exchange enrollment in 2014. Enrollment in private health plans slipped from 38 percent of total enrollment in 2014 to 19 percent this year. Enrollment in Child Health Plus held steady at 7 percent. Among the 117,330 people enrolled in the eight counties of Western New York, 69 percent were enrolled in Medicaid, 8 percent in Child Health Plus and 23 percent in a private health plan.

• Eighty-nine percent of all exchange enrollees, including 68 percent of people who signed up for a private plan, were uninsured at the time they applied for coverage.

• People who enrolled in a private health plan selected a plan in one of a number of “metal” tiers. Twelve percent of enrollees selected a platinum plan, which generally offers higher premiums but lower out-of-pocket costs; 10 percent enrolled in a gold plan; 68 percent enrolled in one of several silver plans; 18 percent enrolled in a bronze plan, which generally offers lower premiums but higher out-of-pocket costs; and 2 percent enrolled in a catastrophic plan. That is consistent with the 2014 metal tier breakdown, the state reported.

• Looking at exchange enrollment by age, 26 percent of enrollees are younger than 18, 34 percent are in the 18-to-34 age range coveted by insurers, and 40 percent are between the ages of 35 and 64. When broken down by gender, 52 percent of exchange enrollees are women and 48 percent are men, comparable to the gender split in the overall New York population.

• Western New York, which has 8 percent of the state’s population under the age of 65, was underrepresented on the exchange, where it has 5 percent of the statewide enrollees. It was a similar situation on Long Island and in the rest of Upstate New York. New York City, however, with 43 percent of New York’s under-65 population, was overrepresented, with 56 percent of exchange enrollment.

• Statewide, Fidelis Care, at 20 percent, and Health Republic Insurance, at 19 percent, had the largest share of exchange enrollment in private health plans. The three largest insurers in this area – BlueCross BlueShield of Western New York, Independent Health and Univera Healthcare – each had 1 percent or less of statewide enrollment.

• Within Western New York, Health Republic Insurance, which generally offered the plans with the lowest premiums on the insurance exchange, had by far the highest share of private-plan enrollment. Health Republic had 43 percent of enrollment here, followed by BlueCross BlueShield at 20 percent, Fidelis Care at 18 percent, Independent Health at 13 percent, MVP Health Care at 3 percent and Univera at 2 percent.