Guest blog by Lois Uttley, MPP, Director of Raising Women’s Voices-NY. Six years after the Affordable Care Act (ACA) was signed into law and three years after the ACA insurance marketplaces opened, the nation’s uninsured rate has dropped to the lowest level ever recorded. Between 2010 and 2016, the percentage of people without health insurance fell by nearly half, from 16 percent to 8.6 percent. The sharp decline is illustrated in this chart from Vox. The previous low of 9.1 percent was recorded in 2015.
The new numbers were released last week by the National Center for Health Statistics, and are based on the National Interview Survey conducted during the first quarter of 2016. The survey uncovered some important variations among population groups when it comes to health insurance. For example:
- Only 5 percent of children 17 and younger are now uninsured. Of those, 42.1 percent had public coverage and 54.9 percent had private coverage.
- Hispanic adults had the greatest decline in un-insurance, going from 40.6 percent in 2013 to 24.5 percent in 2016. But that reduced rate was still much higher than the 2016 rates for non-Hispanic Black (13 percent), white (8.4 percent) and Asian adults (6.7 percent).
States Fully Implementing the ACA Show Biggest Drop In Uninsured
The national survey data also reveal striking disparities between rates of un-insurance in states like New York that have fully implemented the ACA – by expanding their Medicaid programs and creating their own health insurance exchanges, or marketplaces – and those that have refused to do so because of conservative political opposition.
First, let’s look at the impact of a state’s decision to expand Medicaid. In the expansion states, the percentage of uninsured adults (ages 18 to 64) dropped by half — from 18.4 percent in 2013 to 9.2 percent in 2016. By contrast, in non-expansion states, the uninsured rate fell somewhat – from 22.7 percent in 2013 to 16.7 percent in 2016 — but still remained high.
Next, let’s look at the difference in uninsured rates between states that opened their own marketplace (or partnered with the federal government to create a marketplace) and those states that refused to do so, and instead defaulted to having a federally-run marketplace. There have been significant declines in uninsured rates in states with their own marketplaces (from 18.7 percent in 2013 to 9.1 percent in 2016) and in partnership marketplace states (from 17.9 percent in 2013 to 8.2 percent this year).
The survey found a different story in the states with federally-run marketplaces. Although even those states experience a drop in the uninsured rate (from 22 percent to 14.5 percent), the 2016 percentage of residents who remain uninsured is much higher than in the other states.
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/.
Late last week, the New York State Department of Financial Services (DFS) called for a hearing to discuss the consequences of a merger of the Anthem and Cigna health insurance companies. HCFANY applauds DFS for this action. HCFANY wrote to DFS in early March shortly after the potential merger was announced. In the letter, HCFANY urged the Department to carefully review this merger and hold a public hearing on how it affects competition in the state Marketplace, which ultimately impacts the costs of premiums and quality of care for consumers.
This merger would combine the second-largest and fourth-largest health insurers in the country and reduce the number of major health insurers in the U.S. from five to three. According to a recent article in Politico, this would mean that Anthem’s total market share would increase to 31 percent in New York State. In the New York Metropolitan area, Anthem would control almost 70 percent of the commercial self-insured market in three of the five boroughs. Increased market share would give Anthem the ability to dictate prices for providers and likely have a negative impact on access to health care for New York’s consumers.
If you would like to weigh in on the proposed Anthem-Cigna merger, there will be a public hearing held on Thursday, September 8 at 10:00 AM in New York City. If you are interested in testifying at the hearing, please write to DFS at New York State Department of Financial Services, Public Affairs Office – Anthem-Cigna Merger New York, NY 10004 OR e-mail firstname.lastname@example.org with the subject line: “ANTHEM-CIGNA 2016 HEARING.” Requests to testify must be received at least five business days prior to the hearing.