Individual Market Rates to Increase by an Average 12.4 Percent in 2024

New Yorkers bracing for health insurance premiums in the individual market are in for some unwelcome news as we look ahead to 2024. According to the latest data, individual market rates are set to surge by an average of 12.4 percent next year. Health plans had initially requested a whopping 22.1 percent average rate hike for 2024, but the Department of Financial Services has managed to trim down this figure through New York’s prior approval process.

The table below presents a comparison of the health plans’ original rate hike requests and the rates that were ultimately approved, giving you insight into how the process affects your healthcare costs. (Feel free to refer to our detailed comments on each rate request.)

The prior approval process serves as a critical safeguard; however, the 12.4 percent increase still poses a financial challenge for many New Yorkers. It underscores the need for New York to explore additional measures to protect consumers from steep premium rises outside of the rate review process. States like Connecticut, Delaware, Massachusetts, Nevada, New Jersey, Oregon, Rhode Island, and Washington have already taken steps in this direction, establishing Health Care Cost Containment task forces or agencies.

For those concerned about the affordability of health insurance, there’s some relief to be found. Most New Yorkers purchasing their own health coverage qualify for subsidies that can help offset premium costs. To explore your options and find out more about available subsidies, head over to the NY State of Health enrollment site. If you need assistance with switching plans or enrolling in affordable health insurance, the Navigator program is here to help. Navigators provide free, unbiased enrollment assistance and can help you understand your eligibility for premium assistance and your coverage options. You can reach out Navigators in the CSS Navigator Network at 888-614-5400 or drop them an email at enroll@cssny.org. You can reach out to assistors with the NY State of Health online here or call at 855-355-5777.

2024 Individual Market Rate Changes
Plan	Requested Increase	Approved Increase	Change
Emblem/HIP	52.7%	25.1%	-52.4%
IHBC	39.2%	25.3%	-35.5%
MetroPlus	26.4%	17.6%	-33.3%
CDPHP	23.5%	12.1%	-48.5%
Highmark	22.6%	13.0%	-42.5%
Healthfirst	20.9%	12.5%	-40.2%
UnitedHealthcare	20.9%	12.2%	-41.6%
Anthem (Formerly Empire HealthPlus)	20.7%	8.6%	-58.5%
Oscar	18.4%	7.9%	-57.1%
Excellus	15.2%	12.2%	-19.7%
MVP	13.3%	6.5%	-51.1%
Overall	22.1%	12.4%	-43.9%

HCFANY worked hard to further a series of important priorities during this year’s budget and legislative session. Read below for a review of what consumers won this legislative session and what remains a priority on the HCFANY policy agenda.

Medical Debt

Over 54,000 New Yorkers were sued by hospitals between 2015 and 2020, and nearly 1.2 million have past due medical debt on their credit reports. Health care prices in New York are some of the highest in the country.

HCFANY applauds the Hochul Administration for requiring that the State Department of Health adopt a uniform application for Hospital Financial Assistance in the budget and commends the legislature for their support of this initiative. The Ounce of Prevention Act, which included the uniform application for Hospital Financial Assistance, had several other important components that did not pass this session. HCFANY will continue to fight for policy that would align hospital financial assistance eligibility with other health care programs offered in New York; increase and clarify patient discounts; eliminate the obsolete asset test that is only applied to poor patients; extend the time to apply for hospital financial assistance to any time during the collection process; and require all providers who practice in a hospital to abide by the hospital’s financial assistance policy.

In another win for consumers, the Department of Health will adopt a Health Insurance Guaranty Fund and a prescription drug price transparency database. HCFANY thanks state policymakers for agreeing to expand the Medicaid program for working people with disabilities.

In the last few days of the legislative session, state lawmakers passed the Fair Medical Debt Reporting Act (S4907/A6275). When signed by the Governor, the legislation will prohibit medical debt from being collected by a consumer reporting agency or included in a consumer report. HCFANY and EMD campaign will follow up with the Hochul Administration to urge the Governor to sign the bill into law.

To learn more about the campaign to #EndMedicalDebt and take action, visit cssny.org/EndMedicalDebt. Burdened by large medical bills? Submit your story to wethepatientsny.org.

Coverage4All

HCFANY is profoundly disappointed that the Hochul Administration’s 1332 Waiver document and state budget language exclude immigrants, backtracking on her promise last Spring. If immigrants had been included, it would have cost the state nothing, and in fact saved New York taxpayers nearly $500 million in bare bones Emergency Medicaid coverage for immigrants.

HCFANY will continue to fight for passage of legislation that serves the needs of New Yorkers who lack health care coverage because of their immigration status. Read more about Coverage4All.

Consumer Assistance

State lawmakers included $3 million in the budget for the Community Health Access to Addiction and Mental Healthcare Project (CHAMP) as well as established an Ombudsman Program for People with Developmental Disabilities. These consumer assistance programs are essential to help New Yorkers navigate the health care system.

However, the wildly successful Community Health Advocates (CHA) program will experience an 9% budget cut due to the Assembly’s reduction in funding. Last year, CHA helped more than 32,000 New Yorkers use their health insurance, saving them nearly $32 million in healthcare related costs. This cut comes right when the 9 million New Yorkers will need to renew their coverage for the first time due to changed rules under the termination of the federal Public Health Emergency.

New York’s individual market premiums might increase by up to 20.4 percent in 2024. New York’s twelve individual market carriers are requesting increases ranging from 13.3 percent by MVP to a shocking 52.8 percent by Emblem. These requested increases far surpass requests from carriers in other states. Carriers in Washington and Michigan are proposing increases of just 9 percent and 5 percent respectively, despite having comparable individual markets.

Rate increases mean New Yorkers would spend a greater share of their budget on health care and less on food, transportation, and other necessities. New York insurance carriers have not offered adequate justification to support their exceedingly large requested price hikes, citing several market wide trends as rationale:

End of the Covid-19 Public Health Emergency (PHE) – During the pandemic, New York stopped requiring people in public health insurance programs to renew (which requires verifying income). In the first two years of the pandemic, over 60,000 people left the individual market as they became eligible for Medicaid and the Essential Plan. Altogether 9.3 million New Yorkers are now renewing their coverage for the first time since 2020 and are doing so in an economy that is improved. Renewal over the next year will reveal higher incomes for many people, making them no longer eligible for public coverage and leaving them to return to the individual market. Based on enrollments so far, that could be 70,000 new people in the individual market. More people in the market should mean reduced premiums, and the Department should implement a uniform reduction to all carriers requested 2024 premium rates.
Covid-19 Testing and Vaccination Costs – Spending on of Covid-19 treatment in 2024 is expected to be significantly lower than previous years because of the combined reduction in frequency and severity of Covid-19 cases in New York. Further, utilization is likely to decline because cost-sharing for Covid-19 testing and treatment is back, effective May 2023. Extensive research documents that even small amounts of cost-sharing reduce health care utilization. The Department should reduce the requested premiums to accurately reflect the change in costs and utilization of Covid-19 related services by individual market consumers in the 2024 plan year.
1332 State Innovation Waiver – The Waiver, which was filed with the federal government in May 2023, seeks to expand the Essential Plan from its current income eligibility cap from 200 to 250 percent of the federal poverty level. It is unlikely that all the procedural steps necessary to implement the Waiver will occur before the start of 2024. Given this uncertain timing, any adjustment for the Waiver should be delayed until 2025 when the State has certainty about whether the Waiver has been approved and when it is implemented.

In our comments, HCFANY breaks down why DFS should curb each carrier’s specific rate requests to protect patients from another unaffordable increase in health care costs. Find your carrier in the list below to see what we had to say:

Tell the State how higher health care costs would impact you here. You can also tell DFS Superintendent Adrienne Harris or Deputy Superintendent John Powell to lower rates on social media by tagging @NYDFS.

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