Numbers, numbers! Initial Takeaways from the Second Open Enrollment Period


Guest Post: Andrea Shang, Health Policy Intern, Community Service Society of New York

The second open enrollment period for New York’s health plan marketplace, NY State of Health, took place from November 15, 2014 to February 15, 2015. The Department of Health and Human Services has released data on this season’s enrollees across all 50 states, plus D.C. Let’s take a look at how New York did.

During the second open enrollment period, over 750,000 New Yorkers enrolled in health plans through the NY State of Health Marketplace: 357,456 individuals were enrolled in Medicaid or CHIP, and 408,841 individuals selected a Qualified Health Plan (QHP). Two-thirds of the QHP enrollees were renewing coverage they had purchased during the first enrollment period. Last year, the NY State Health Foundation (NYSHF) released a survey where 92% of respondents said that they were satisfied with their coverage and would likely renew. Moving forward, more data will be needed to understand consumer satisfaction with Marketplace plans and barriers to keeping insurance.

The report also reveals that nearly one in three of the enrollees who selected a QHP qualified for financial assistance to help them afford health coverage, roughly the same amount as during the first open enrollment period.  And while the report doesn’t have the full picture on demographics data, it shows that people below the age of 35 made up about one-third of the total number of individuals who purchased QHPs this year. Young adults have been a key population to watch during ACA implementation, as they tend to be healthier and have higher rates of uninsurance than older populations.

We anticipate more data from the ASPE and the NY State of Health to be released in the coming months, including breakdowns along the lines of gender, race and ethnicity, plan metal level, and more. Stay tuned!



good news story

Great news! The NY State of Health just announced a Special Enrollment Period (SEP) for uninsured New Yorkers who are facing a tax penalty for 2014. The new SEP will run from March 1 through 11:59 on April 30, 2015.

Some uninsured New Yorkers may first become aware of the tax penalty for not enrolling in coverage when they file this year’s tax returns. The new SEP will allow those New Yorkers to enroll in health coverage now in order to avoid running into the penalty when they file their taxes next year. The tax penalty will increase in 2015 and in 2016.

The State’s announcement followed a similar announcement from the Centers for Medicare and Medicaid Services (CMS) for the Federally-Facilitated Marketplace earlier today.

Opening new coverage opportunities for New York families while helping to ease next year’s tax burden? We think that’s a great combination.

Read the State’s press release here.





Guest post: Elisabeth R. Benjamin, Vice President of Health Initiatives, Community Service Society of New York

The eagerly awaited  Cuomo Administration’s budget bill was posted late Wednesday afternoon, January 21, 2015.  The health section is a mere 170 pages long, making it a tough winter evening read. HCFANY’s policy experts and allies will parse the details over the next week and post a detailed reaction…err, later.  However, we have identified two bits of good news for New York’s health insurance consumers right away.

First, the Governor Cuomo proposed a broad-based insurance financing mechanism for the NY State of Health Marketplace.  This is good news for individuals and small employers because it means that those folks who are insured through the Marketplace will not disproportionately shoulder the burden of guaranteeing affordable, quality health coverage for New Yorkers.  The alternative of placing a financing fee on marketplace enrollees would have resulted in Marketplace enrollees paying higher insurance rates than individuals and groups covered by plans purchased outside of the Marketplace.  The broad-based financing mechanism proposed by the Administration will ensure a level playing field for all New York’s health insurance consumers.

The second piece of great news is that the Cuomo Administration has proposed $2.5 million in state funding for the Community Health Advocates (CHA) program.  CHA has offered information about how to enroll and use health insurance coverage and care to nearly 200,000 New Yorkers since its launch in late 2010.  CHA’s  network of 21 community based organizations, small business serving groups (like Chambers of Commerce), and specialists serve New Yorkers both in their local communities and through a live answer help-line.  Together, CHA’s groups act as an “HR” department for New York’s health insurance consumers who need a little extra help accessing or understanding how to get care.

HCFANY lauds Governor Cuomo’s Administration on these proposals and looks forward to working with the Administration during this legislative season.

 2015 HCFANY Annual Meeting 085

Courtney Burke (right), Deputy Secretary for Health for New York State accepts HCFANY’s 2015 Health Consumer Champion Award from Kate Breslin (left), President and CEO of Schuyler Center for Analysis and Advocacy.

 Guest Post: Bob Cohen, Policy Director, Citizen Action of New York

Close to 100 health care advocates, coming from every corner of the state (Long Island, New York City, the Hudson Valley, the Capital District, the North Country, the Southern Tier and Central New York), braved the wintry weather on January 9th for HCFANY’s 2015 annual meeting in Albany.

In the opening panel, three HCFANY Steering Committee members set the stage by reviewing recent HCFANY successes of the past year and the challenges we face, particularly on the federal level. The panelists reviewed HCFANY’s role in promoting the state’s recent health coverage expansions, including the enrollment of over 1 million New Yorkers in the NY State of Health Marketplace during its first year and the creation of a Basic Health Program to offer more affordable coverage to lower-income working New Yorkers (see attached presentation notes). But key challenges lie ahead, including potential attempts by Congress to undermine the Affordable Care Act.  Advocates need to be vigilant to ensure that Congress does not chip away at the law with, for example, cuts to subsidies to buy health coverage. Another key issue to watch in 2015 is the September expiration of funding for the Children’s Health Insurance Program (Child Health Plus in New York), which could endanger the coverage of hundreds of thousands of New York children.

A second panel on HCFANY’s policy agenda for 2015 outlined next steps for ensuring quality, affordable coverage in the state, including covering all immigrants, maintaining a strong, statewide consumer assistance program, and ensuring that consumers purchasing plans through NY State of Health have access to out-of-network coverage.

And attendees heard an important briefing on the state’s recent moves towards payment and delivery systems reform.  Panelists emphasized that as New York moves rapidly forward on these initiatives, consumer advocates have to weigh in to ensure that consumers are protected and see the benefits of the restructuring. Presentations are available here, here and here.

Finally, attendees had the chance to put lessons into action, by developing action plans for HCFANY’s policy agenda. Please watch this space to see how HCFANY’s work unfolds during this year’s legislative session!