HCFANY is thankful to have the opportunity to testify at the 2025 Joint Legislative Budget Hearing on Health. Our fully detailed written comments are here. The Executive Budget includes many proposals to help protect and enhance New Yorker’s access to affordable health coverage. However, the current federal landscape on health care access is uncertain, as proposed cuts to federal health programs could cost the State $10 billion to maintain health coverage for New Yorkers (Learn how these federal threats affect New Yorkers statewide and by Congressional District here).  

The Managed Care Organization (MCO) tax revenue provides an opportunity for the State to ensure New Yorkers have access to and can afford health care. HCFANY urges the Legislature to consider alternatives to the distribution of $1.4 billion of this tax revenue, which currently does not include direct support for patients.  

HCFANY recommends:  

1. Expanding subsidies for Child Health Plus to eliminate premium cliffs and align coverage start dates to the first day of the month of application.  

This would help ensure that middle-income families can afford their children’s health insurance. Once families surpass the 400% Federal Poverty Level (FPL) income threshold, their children’s annual insurance premiums increase by around $3,000 per child. Additionally, the State should follow similar rules as Medicaid and the Essential Plan for CHP coverage start dates. 

2. Addressing New York’s expensive health care system.  

New York is ranked second in the nation for the most health care spending per person, and HCFANY proposes three solutions to remedy this: 

1. Implement an independent New York Office of Health Care Affordability, like the model created in California.  

2. Include provisions of the Fair Pricing Act (S705|A2140) to ensure consumers and payers are charged a fair reimbursement rate for routine medical services, regardless of where the patient gets care.  

3. Improve patient outcomes and reduce inequities by including the provision of the Primary Care Investment Act (S1634|A1915A).  

3. Creating a principal reserve or a rainy-day fund to ensure New Yorker’s access to care is protected from the threats of federal cuts.  

This funding could help keep lawfully present immigrants enrolled in Medicaid covered if the federal government cuts access to health insurance for this population.  

4. Increasing funding for consumer assistance programs like Navigators and the Community Health Advocates (CHA) program.  

These are only a few initiatives that HCFANY is urging the Legislature to consider, please see our full written testimony here. 

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 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%