Premium Requests for 2018 Are Out – Let the State Know What You Think About It!

vintage-style-sale-tags-design_z1f7nlPu_LHealth insurance companies have to get permission from insurance regulators for their prices every year, whether premiums are increasing, decreasing, or staying the same. In New York, our insurance regulators (the Department of Financial Services, or DFS) consider public comments when making their decision. To help consumers make informed comments, DFS posts the insurers’ applications on their website. Insurers also send letters to their customers informing them about their rate request and with instructions for commenting. Public comments are due by July 9.

The posted applications show that New York’s insurance market is robust, despite predictions that the marketplaces created by the Affordable Care Act would “explode” this year. Consumers shopping for individual or small group plans for 2018 still have lots of options at different price points. Insurers are asking for slightly smaller increases than they did last year (an average 16.6 percent increase in the individual market and 11.5 percent in the small group market). But of course, any increase can be hard for consumers and small business to bear. Consumers should remember that if you get premium assistance through the Advanced Premium Tax Credits, that assistance will reduce the impact of any rate increase. People should also understand that the requested amounts they see in the letters and on the DFS website are not final. The companies have to prove that their costs have gone up and that they have to raise prices to maintain a healthy business. If they can’t do that, DFS will reduce their requests.

HCFANY submits comments every year. Those letters (you can read the ones from last year here) include a detailed review of the companies’ applications. But comments do not have to be so detailed.  You can find our guide to the process here.  We also posted some example letters to help people get started (available here). But it is valuable for DFS to hear from consumers in their own words, so don’t feel like you have to stick to one template. Once you have written out what you want to say, you can copy and paste it into the form provided by DFS.

sad childMedicaid is the single largest insurer for children in the United States. The program covers more than 35.5 million children nation-wide and more than 2 million children in New York State alone. On May 4, the House of Representatives voted to repeal and replace the Affordable Care Act (ACA) and cut more than $830 billion from the Medicaid program. In addition to these dramatic cuts, Congress has also proposed to lower the federal minimum Medicaid eligibility threshold for children under 19 from 138 percent of the Federal Poverty Level (FPL) (about $28,000 for a family of three) to 100 percent of FPL (about $20,000 for a family of three). A new policy brief from the Institute for Child, Youth, and Family Policy at Brandeis University shows what these cuts to Medicaid and change in eligibility will mean for school-aged children.

According to the policy brief, there are currently 15.2 million children eligible for Medicaid coverage in the U.S. The proposed change in the federal minimum eligibility for the Medicaid program would reduce the number of eligible children by 4.7 million. The brief also explains that eligible children are disproportionately Black and Hispanic or Latino. This is also true in New York State. According to the brief, New York ranks fourth in the nation for the number of Hispanic or Latino children who would lose Medicaid eligibility under this change (90,600) and fifth for the number of Black children who would lose Medicaid eligibility (48,400).

New York State has always been a leader in children’s health coverage. New York currently has an insurance rate for children of more than 97 percent, and all children under the age of 19 are eligible for health insurance regardless of immigration status. New York State also has a Medicaid eligibility level for school-aged children of 149 percent of FPL (about $30,000 for a family of three) through 2019, which is greater than the federal minimum eligibility under the ACA. However, even with these many steps in the right direction, Black and Hispanic or Latino children remain more likely to be uninsured than other New York children. Cuts to Medicaid and reduction of the federal Medicaid eligibility level would be a huge step backward and only serve to exacerbate existing health inequities for New York’s children.

keep goingLast Thursday, the House of Representatives passed the American Health Care Act (AHCA). If the AHCA were to become law, 2.7 New Yorkers would lose their health insurance, Medicaid would be cut by more than $800 billion, and protections for people with pre-existing conditions would be severely weakened. Seven of New York State’s nine Republican Representatives voted in favor of the bill; two Republicans voted against it; and all 18 Democrats voted against it. The bill is now in the Senate for further consideration and revision.

However, the conversation on the AHCA and what it will mean for New Yorkers is not over! Members of Congress left for recess shortly after the vote and came home to face constituents, many of whom were dismayed by the passage of the devastating legislation.

In the days following the vote, town halls took place in the districts of Representatives King, Faso, Stefanik and Reed, who all voted in favor of the AHCA. Representatives King and Faso did not attend the town halls in their districts, and Representatives Collins, Tenney, and Zeldin, who also voted in favor of the bill, did not host town halls. This video from the town hall in Representative Reed’s district provides some insight into how some constituents are feeling about the AHCA and how they think it would affect their care.

It is not too late to call your Representatives and tell them how you feel about the AHCA and about their votes. You can call your Representatives in their districts using the numbers listed here:

Voted Against the AHCA (Thank you!!)

  • Congressman Dan Donovan
    • Brooklyn Office (718) 630-5277
    • Staten Island Office (718) 351-1062
  • Congressman John Katko
    • Auburn/Lyons Offices (315) 253-4068
    • Oswego/Syracuse Offices (315) 423-5657

Voted for the AHCA (Start defending the health of constituents over tax cuts!)

  • Congressman Pete King
    • Massapequa Office (516) 541-6602
  • Congressman Tom Reed
    • Corning Office  (607) 654-7566
    • Geneva Office (315) 759-5229
    • Ithaca Office (607) 222-2027
    • Jamestown Office (716) 708-6369
    • Olean Office (716) 806-1069
  • Congresswoman Elise Stefanik
    • Glens Falls Office (518) 743-0964
    • Plattsburgh Office (518) 561-2324
    • Watertown Office (315) 782-1291
  • Congresswoman Claudia Tenney
    • Binghamton Office (607) 376-6002
    • New Hartford Office (315) 732-0713
  • Congressman  Lee Zeldin
    • Patchogue Office (631) 289-1097
    • East End Office (631) 209-4235

ExpensiveAccording to a new report from the Kaiser Family Foundation, eliminating cost sharing reductions (CSRs), or subsidies that lower the out-of-pocket costs for moderate-income consumers, would increase overall costs to federal government instead of saving money.

Nationally, CSRs are worth approximately $7 billion annually and reduce out-of-pocket costs for moderate income consumers by $3,350 to $3,600 per year.

CSRs are especially important for New York because CSRs provide nearly $1 billion annually in funding for the Essential Plan, the State’s Basic Health Program, which covers nearly 700,000 New Yorkers.

Continued funding for CSRs is at risk. In 2016, members of the House of Representatives sued the Administration to block funding for CSRs and argued that the Administration had paid for them without Congressional authority. A district court ruled in favor of the House, and the case is now on appeal. The current Administration now has to decide whether or not to move forward with the appeal. If the appeal is dropped, and Congress does not appropriate the CSR funding, millions of consumers may no longer be able to afford coverage.

Although it would appear that eliminating CSRs would save the federal government money, the Kaiser Family Foundation explains that any savings would be coupled with significant increases in costs for the Advanced Premium Tax Credits (APTCs) that lower monthly premiums. The report estimates that ending CSRs would actually result in a net increase in federal costs of $2.3 billion.