The NY State of Health’s (NYSOH) 2016 Open Enrollment Report shows that increased efforts to reach Limited English Proficient populations are making progress. This year, 20 percent of NYSOH enrollees indicated a language other than English as their preferred language compared to 18 percent in 2015. This increase is an important reflection of the diversity of our state.
To encourage outreach, NYSOH made consumer education materials available in 23 languages other than English, including five additional languages that were not available in 2015: Burmese, Karen, Somali, Swahili, and Tigrinya. NYSOH’s Customer Service Center also provided assistance to consumers in 93 languages other than English with an average of 20 percent of all calls to the Customer Service Center each month were answered in a language other than English compared to only 14 percent in 2015. Additionally, Navigators provided assistance in 37 languages other than English.
Gaps in information remain about New York’s diverse immigrant communities and their experiences enrolling in coverage through the NYSOH. Although this year’s Open Enrollment Report provides great information about enrollment for seven languages: Chinese, English, French, Haitian Creole, Italian, Korean, Spanish, and Russian, the report does not provide insight into whether callers in additional languages were able to enroll after reaching the call center. The NYSOH Navigator program funds enrollment but not outreach activities. Last year, HCFANY urged the State to provide dedicated outreach funding to small community-based organizations that best know difficult to reach immigrant rural populations.
Guest blog by Bob Cohen, Esq. Policy Director at Citizen Action of New York and Public Policy and Education Fund of New York.
Fall is almost here, which means it’s time to start thinking about open enrollment! For the fourth consecutive year, HCFANY is teaming up with the Health Education Project of NY (HEPNY) and other groups to hold outreach and enrollment summits throughout New York State. This year, we’ll also be focusing on post-enrollment challenges. We encourage navigators, certified application counselors, health advocates, community members, health providers, union members, health insurance plan representatives, and small business representatives to attend.
Over 2.5 million New Yorkers filed applied for health coverage with NY State of Health last year — a great success!
This is a great opportunity to focus on continuing issues. First, there are still many “hard-to-reach” individuals that still have not enrolled in health coverage because of issues like language barriers and lack of information even if they qualify for free or low-cost coverage through Medicaid or the Essential Plan. Second, some people are unfamiliar with many elements of how health coverage works, like deductibles and co-pays and navigating their plan’s network. Other individuals do not know what to do if they experience a problem, like medical bills that seem incorrect.
Each summit will feature a presentation on the state of outreach and enrollment by a NY State of Health representative, followed by speakers from Community Health Advocates (CHA) about how they can help consumers with post-enrollment issues, and finally presentations by the Health Care Education Project and Lois Uttley, Director of Raising Women’s Voices-New York, on health literacy. The first summit will be held on Wednesday, September 28 at the 1199SEIU in Albany from 11:00 AM to 2:00 PM. Please see the Statewide Flyer for the complete schedule of outreach and enrollment summits.
Once again New York is leading the nation as one of only two states to implement a Basic Health Plan (BHP). As of January 31, 379,599 New Yorkers enrolled in comprehensive, affordable coverage through the New York’s BHP, branded the Essential Plan, which launched in 2016. A few weeks ago, the NY State of Health (NYSOH) released its report on the third open enrollment period, which ran from November 1, 2015 through January 31, 2016. HCFANY is excited to see so many consumers gaining access to health care through the EP in its first year.
The EP is meeting an important need for consumers in New York, particularly for those with incomes between 138 and 200 of the Federal Poverty Level (FPL). Before the implementation of the Essential Plan, individuals at this income level would only have been eligible to purchase Qualified Health Plans (QHP) with financial assistance, and many continued to face financial barriers to coverage. With the EP, low- and moderate income individuals can now receive coverage comparable to that of a QHP for a premium of $0 or $20 and no annual deductible. The average consumer saves over $1,100 compared to QHP coverage. This increased affordability has resulted in high enrollment levels for EP eligible individuals. According to NYSOH’s open enrollment report, 98 percent of individuals determined to be eligible for the Essential Plan enrolled compared to only 58 percent of individuals eligible for QHP.
Essential Plan coverage is also available to individuals under age 65 with incomes below 138 percent of the Federal Poverty Level (FPL) who are lawfully present in the United States, but have not met the five-year bar to qualify for Medicaid as well as lawfully present immigrants with incomes 138 to 200 percent of FPL.
Like Medicaid and Child Health Plus, individuals and families eligible for the EP can enroll throughout the year.
To enroll or learn more about the Essential Plan, contact NYSOH at (855)-355-5777 or www.nystateofhealth.ny.gov.You can also get free one-on-one help from a Navigator or Certified Application Counselor, certified by NY State of Health, who serves your area at http://info.nystateofhealth.ny.gov/IPANavigatorMap. Or contact Community Health Advocates at (888)-614-5400 or http://www.communityhealthadvocates.org/.
Premiums in New York will increase this year for people buying plans in the individual and small group markets. But thanks to our public rate review process, the increases are smaller than what carriers requested. Carriers asked the Department of Financial Services (DFS) to approve an average 18 percent increase (learn more about rate review here). After reviewing their requests and public comments (including ten letters submitted by HCFANY), DFS approved an increase of 16.6 percent for the individual market and 8.3 percent for the small group market. DFS estimates that this will save consumers $302 million in 2017.
While any premium increase is difficult for consumers to bear, rate review limits increases to those that are necessary because of legitimate cost trends in the health insurance market. Other states also have a rate review process, but New York’s is special because it allows public participation. Carriers who want to sell insurance in our marketplace have to publicly justify their requests for premium increases. And the public can tell the decision-makers at DFS exactly how premium costs impact their lives. Rate review can’t eliminate all premium increases, but for the third year in a row, it has reduced them (we blogged about previous results in 2015 and 2014).
Consumers who are concerned about high premiums should remember that these average increases will not necessarily result in large increases for individuals, because most individuals who purchase marketplace plans receive premium subsidies. Premium increases should also be considered in context. The Affordable Care Act (ACA) did not eliminate premium increases, but it did successfully slow them down. Consumers are paying lower premiums today than was projected pre-ACA and are getting plans that offer significantly better benefits for their money.
Additionally, concerned consumers should take advantage of the Marketplaces created by the Affordable Care Act to shop around. Thanks to the New York State of Health, it has never been easier for consumers to compare their health insurance options. And every New Yorker can find local, in-person enrollment assistors to help make the best choice. Rate review is one of your tools for keeping premiums down in New York – open enrollment, which starts November 1, is another.