Prior Approval Will Save New Yorkers an Estimated $225 Million in 2018

Posted August, 16 2017 by Amanda Dunker

The results of New York’s prior approval process for health insurance rates are in, and again it’s good news for consumers. The New York State Department of Financial Services (DFS) reduced the requested rates by 3.8 percent for individual plans and 2.4 percent for small business plans. Insurers had requested increases of 17.7 and 11.7 percent respectively. The downward adjustment adds up to an estimated $225 million that consumers won’t have to spend on premiums next year. (You can see our comments on the plans’ applications here, and our explanation of the rate review process here).

Consumers will still experience premium increases: 13.9 percent for individual plans and 9.3 percent for small businesses. Any premium increase is difficult for consumers. However, the prior approval process limits allowable increases to those that are supported by things like health care prices. Insurance companies in New York are not allowed to raise their prices unless they make a good case for it. And even after another year of increases, premiums in New York’s individual market are still 55 percent lower than they were before the Affordable Care Act took effect. New York has multiple insurance companies in every part of the state, so consumers should make sure to shop around during open enrollment for the best deal.

Consumers should also ensure that they are benefiting from all the assistance provided by the Affordable Care Act, including tax credits which are based on income. The tax credits mean that some people will actually experience a decrease in their premiums next year. Purchasing your plan through the New York State of Health or with the help of an in-person assistor is the best way to make sure you get all the assistance you are eligible for.