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New York health insurance exchange sign-up starts today

Open enrollment begins Tuesday for New York’s health insurance exchange, which serves people who don’t receive coverage through an employer or Medicare.

People have until Jan. 31 to sign up through the NY State of Health exchange, a key piece of the Affordable Care Act meant to reduce the uninsured rate and lower overall spending on health care.

Consumers shopping on the exchange should find the same full range of plan choices as last year and expect to pay an average increase of 16.6 percent for individual coverage, according to state regulators.

That contrasts with the exchanges in the states operated by the federal government, where many insurers are dropping out of the Obamacare marketplaces and a significant number of insurance shoppers are facing steep price increases.

The U.S. Department of Health and Human Services reported last week that a mid-level health plan purchased through the HealthCare.gov site will rise in price by an average 25 percent for 2017, and that 1 in 5 shoppers on the site will find only one insurance company serving them.

Federal health care reform has remained controversial since its launch. Concerns about the affordability of coverage purchased through the exchanges have become an issue in the presidential campaign as the fourth open enrollment period begins.

New York had a low uninsured rate even before the first open enrollment period started, in fall 2013, but state officials say the exchange has helped to bring it even lower.

The percentage of state residents without health insurance fell from 10 percent in 2013 to 5 percent in September 2015, according to the Centers for Disease Control and Prevention.

Enrollment in the NY State of Health stood at 2.8 million people as of Jan. 31, the end of the most recent open enrollment period, with 69 percent enrolled through Medicaid, the jointly-funded state and federal health insurance program for low-income people and others who need assistance.

In Western New York, enrollment was 150,493, according to the state Health Department.

Five insurance companies are selling coverage through the exchange in at least one of the eight counties of Western New York for 2017, the same number as in 2016: BlueCross BlueShield of Western New York, Fidelis Care New York, Independent Health, Univera Healthcare and MVP Health Plan.

State insurance regulators approved rate increases ranging from 8.7 percent to 19.6 percent for individual plans sold on and off the exchange next year in the region. Insurers cited rising health care and drug costs, government mandates and other factors as driving the rate hike requests.

Consumers shopping on the exchange can choose from a range of qualified plans sold on different “metal” tiers with different price points, as well as the low-cost, no-frills Essential plan or Medicaid if they qualify based on income.

People buying health plans may be eligible for a subsidy, depending on their income. Half of enrollees in a qualified health plan in 2016 received a premium tax credit – averaging $170 per month – the Health Department said in its most recent enrollment report.

Once again, people have to pay an income-tax penalty if they go without insurance. The penalty for 2017 remains 2.5 percent of income, but the flat amount, which was $695 for 2016, will be adjusted for inflation for 2017.

The state Attorney General’s Office issued some guidelines for consumers shopping for health insurance through the exchange. You can see them here.

Call (855) 355-5777 to speak to a certified navigator about enrolling in a NY State of Health plan or visit https://nystateofhealth.ny.gov/ to get more information.

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