New York State of Health announces plans for 2016


Today the New York State of Health Marketplace announced which health insurance carriers will be offering plans on the Marketplace for 2016. This encompasses Qualified Health Plans for both individuals and small businesses, the new Essential Plan, and stand-alone dental plans.

The 200,000 individuals who hold policies with Health Republic will have to go shopping for new plans when Open Enrollment begins on November 1st. The CO-OP is winding down operations and no longer issuing renewals. The good news is that sixteen carriers will offer individual QHPs in 2016, and eight for the Small Business Marketplace (SHOP). The definition of a small business is new for 2016: firms with 100 or fewer full time equivalent employees can use SHOP – up from 50 employees in 2015.

While insurers and consumers alike are new to the Essential Plan, there is a strong show of support with 13 carriers offering plans for 2016. Consumers can use this interactive map to see which plans are offered in their county. Some counties, like the Bronx, have eight plans on offer, while New Yorkers in other counties, like Putnam and Schoharie, will only have one plan option if they qualify for the Essential Plan.

The stand-alone dental market is largely the same as 2015, with 11 carriers offering plans, 3 of which offer plans in every county in the state. The maps for dental, individual, and small business plans are available here.



A report released this week by Kaiser Family Foundation shows that 58% of uninsured New Yorkers are eligible for free or subsidized health coverage. The majority of them – 548,000 people – are eligible but not enrolled in Medicaid. There are several reasons why people who are eligible for Medicaid have not enrolled: some do not know they’re now eligible under the Affordable Care Act’s Medicaid expansion, some avoid Medicaid because of the stigma of poverty attached to the program, and some have had their income drop since they last applied for coverage.

The 317,000 New Yorkers who are uninsured but would qualify for financial assistance (such as Cost Sharing Reductions and Advance Premium Tax Credits) on the Marketplace includes consumers who are newly-eligible for the Essential Plan, New York’s forthcoming Basic Health Program. Consumers enrolled in the Essential Plan will have monthly premiums of $0 or $20 a month, no deductible, and very low copays; this combination should assuage the fears of people who believe health coverage is too expensive. The New York State of Health hopes to draw consumers back during the third Open Enrollment period, which begins on November 1, by highlighting these new levels of affordability. They’ll be targeting these 317,000 New Yorkers with videos, social media campaigns, and catchy new graphics (stay tuned for more!).

Nearly a third of uninsured New Yorkers – 457,000 people – are unauthorized immigrants. New York City Mayor Bill de Blasio’s recent announcement on connecting immigrants to care through a “Direct Access” program was a crucial first step for those immigrants living in the City, and Health Care for All New York will continue to advocate for comprehensive health insurance coverage for our undocumented neighbors. New York State has done a fabulous job in the first two Open Enrollment periods in connecting people to coverage, and the rollout of the Essential Plan will be another step in the right direction. A critical next step for closing the coverage gap in New York will be expanding affordable coverage to New Yorkers who are excluded from coverage options because of immigration status.

immigrant family

New York City Mayor Bill de Blasio announced a new plan yesterday to connect the City’s undocumented immigrants with a soon-to-be launched “Direct Access” health care program. The Direct Access program is not insurance coverage, but a network of health care providers with the cultural competency and linguistic diversity to serve New York’s many immigrant communities.

The Direct Access program is outlined in a newly released report from the Mayor’s Task Force on Immigrant Health Care Access, available here. HCFANY Steering Committee members Becca Telzak (Make the Road New York), Claudia Calhoon (New York Immigration Coalition), Sheelah Feinberg (Coalition for Asian American Children and Families), and Elisabeth Benjamin (Community Service Society of New York) served on the Task Force that wrote the report. The report underscores that coverage is the gold standard for care and recommends that ultimately a coverage-based solution be developed for immigrants:

The Task Force believes that all individuals, regardless of immigration status, should have access to affordable health insurance coverage. Accordingly, it urges the State of New York to expand public health insurance options to the undocumented population and urges Congress and the federal government to remove harmful restrictions on immigrant health insurance access.

Consistent with the report’s findings, HCFANY will continue advocated for health coverage for all New Yorkers, regardless of documentation status and lauds New York City for taking this important interim step while the goal is secured.

The third open enrollment period for the New York State of Health begins on November 1, 2015, and the Healthcare Education Project and HCFANY member organizations are already busy preparing.

Building on two successful years of enrollment summits, this year’s 8 regional summits will continue to bring together stakeholders and community leaders to develop coordinated plans for outreach and open enrollment in 2015.

Navigators, health advocacy groups, health insurance plans, community groups, healthcare facilities, Certified Application Counselors, unions and small business representatives will come together to examine best practices, and share strategies, resources and partnerships to maximize enrollment in New York State of Health, the state’s insurance marketplace, taking into account the introduction of the Essential Plan in 2016.  Participants will be able to volunteer for a number of enrollment and outreach tasks, and get their organizations involved.

Over 2.1 million New Yorkers enrolled in a health plan through Feb 28, 2015. This surpassed the New York State of Health goal to enroll 1.1 million New Yorkers in the first three years, and we’re continuing to work towards coverage for all New Yorkers!

Below is a list of all 8 summits. Local groups should come to the summit that covers their region. Statewide groups are urged to send their local affiliates. Contact local coordinators listed below with questions and to RSVP.



Thursday, Sept. 17, 2015 • 9:00 am – 12:00 noon

Ramada Inn Conference Center, 542 Route 9, Fishkill (exit 13 off I-84), NY 12524

To register: Visit



Friday, Sept. 25, 2015 • 12:00 noon – 3:00 pm

1199SEIU Auditorium, 310 W. 43rd St., NY, NY 10036

To register: Visit



Monday, Oct. 5, 2015 • 10:00 am – 1:00 pm

1199SEIU, 100 Duffy Avenue, Suite 300W, Hicksville, NY 11801

To register: Email Luis Valenzuela at


CENTRAL NEW YORK (Binghamton, Syracuse)

Tuesday, Oct. 6, 2015 • 1:00 – 4:00 pm

Southern Tier Independence Center, 135 E. Frederick St, Binghamton, NY 13904

To register: Contact Mary Clark at 607-723-0110 or by email at



Tuesday, Oct. 6, 2015 • 10:00 am – 1:00 pm

Staten Island Mental Health Society, Safir Auditorium, 669 Castleton Ave, Staten Island, NY 10301

To register: Email Nicole O’Loughlin at Nicole.O’ or call (917)543-3200.



Thursday, Oct. 8, 2015 • 12:30 pm – 4:00 pm

SEIU Albany, 155 Washington Ave., Albany, NY 12210

To register: Visit or email Sara Couch at or call 518-222-1711.


WESTERN NEW YORK (Buffalo, Rochester)

Thursday, Oct. 8, 2015 • 9:00 am – 12 noon

1199SEIU Conference Room, 2421 Main Street, Buffalo, NY 14214

To register: Contact Bill Covington by phone at 716.995.3705 or by email at



Wednesday, Oct. 21, 2015 • 10:00 am – 1:00 pm

Bedford Stuyvesant Restoration Plaza, 1368 Fulton St, Brooklyn, NY 11216

To register: Email Marcelle Dinnall at or Jennifer Clarke-Craig at    


This event series is being held in cooperation with New York State of Health,



Citizen Action of New York • Community Health Care Association of New York State (CHCANYS) • Community Service Society of New York • Healthcare Education Project (1199SEIU/GNYHA) • Health Care For All New York • Make the Road NY • Raising Women’s Voices-NY