Tell New York to Lower Insurance Premiums by June 28
New York’s individual market insurance carriers plan to increase premiums by an average of 17% in 2025. This month, consumers have the opportunity to weigh in to make our voices heard. The State already approved premium increases of over 14% on average in 2024, another 17% would make health insurance out of reach for many New Yorkers.
Depending on your carrier, premiums could increase between 9% and 51% in 2025, impacting New Yorkers’ ability to spend on necessities such as health care, groceries, and transportation. It is critical that consumer voices are heard to prevent health insurance from being even more unaffordable.
Make your voice heard: submit a public comment before June 28, 2024 sharing how steep premium increases would impact you and your loved ones.
Tell the State how more expensive premiums would impact you by leaving a public comment here by Friday, June 28. Share a personal story on your healthcare needs and affordability concerns you have, or use the following sample for guidance:
“My plan, (insert carrier name), has asked for a (insert from table below) % premium increase. I already struggle to afford health insurance and that increase would require me to sacrifice ____.”
New York State of Health (NYSOH) has included several exciting new initiatives in its 2025 Plan Invitation. Though some of the initiatives are subject to federal approval, HCFANY is thrilled about the improvements to the quality and affordability of health insurance plans offered on the NYSOH marketplace. Here are some key wins for consumers:
- Eliminating in-network cost-sharing for New Yorkers with diabetes in State-regulated plans. The program applies to medical care, prescription drugs, supplies, and diagnostics related to the primary diagnosis of diabetes.
- Cost-sharing subsidies for low- and moderate-income New Yorkers on Qualified Health Plans (QHP) with incomes up to 400 percent of the Federal Poverty Level (FPL), or $125,000 for a family of four. If approved, NYSOH will use $315 million of federal waiver passthrough funding that was allocated for these subsidies in the 2024-25 State Budget.
- Expanding maternal health cost-sharing initiatives to QHPs to allow pregnant and post-partum New Yorkers to access zero copay care for almost all diagnoses and services through 12 months postpartum.
- Eliminating waiting periods for standalone dental plans offered through NYSOH for all adult dental services (exception for orthodontics), allowing New Yorkers to use the coverage they are paying for.
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% |
New Yorkers who buy health insurance in the individual market will see premiums go up by an average of 9.7% in 2023. Health plans originally requested an average increase of 18.7%, but this was reduced by almost half through New York’s prior approval process. The table below shows the plan’s requests and the rates that were approved. (You can find our comments on each rate request here.)
Prior approval is an important tool—the reduction will save consumers an estimated $167.1 million. However, for consumers, a 9.7% rate increase is still too high. New York should do more to protect consumers from premium increases outside of the rate review process. For example, Connecticut, Delaware, Massachusetts, Nevada, New Jersey, Oregon, Rhode Island, and Washington State have Health Care Cost Containment task forces or agencies. California created an Office of Health Care Affordability in its most recent state budget.
Are you worried about affording health insurance? Most New Yorkers who buy their own health insurance receive subsidies to help pay their premiums. You can explore your options at the NY State of Health enrollment site. You can also get free help switching plans or enrolling in affordable health insurance through the Navigator program by calling 888-614-5400 or emailing enroll@cssny.org.
| 2023 Individual Market Rate Changes | |||
| Plan | Requested Increase | Approved Increase | Change |
| Emblem/HIP | 34.6% | 9.0% | -11.9% |
| CDPHP | 28.4% | 16.5% | -25.6% |
| NYQHC/Fidelis | 23.2% | 12.4% | -10.8% |
| Highmark | 20.5% | 12.8% | -7.7% |
| MVP | 19.2% | 10.1% | -9.1% |
| Unitedhealthcare | 16.1% | 9.2% | -6.9% |
| Oscar | 14.6% | 6.5% | -8.1% |
| Excellus | 14.0% | 10.0% | -4.0% |
| Healthfirst | 13.0% | 8.3% | -4.7% |
| MetroPlus | 13.0% | 8.1% | -4.9% |
| Independent Health | 10.2% | 6.1% | -4.1% |
| HealthPlus (previously Empire) | 6.9% | 0.5% | -6.4% |
| Overall | 18.7% | 9.7% | -9.0% |