The New York State of Health announced today that record numbers of New Yorkers have used the site to enroll in health coverage. This is amazing news, especially since many other states are seeing their numbers of uninsured people increase this year. New York State has a long history of helping people get health coverage. The Affordable Care Act (ACA) allowed the State to make huge amount of progress in that agenda, including the creation of the New York State of Health Marketplace (NYSOH). Altogether, over 4.7 million New Yorkers have bought or enrolled in coverage this year using NYSOH.
NYSOH allows New Yorkers to sign up for four different types of coverage. When you make an account, you provide information about how big your family is and your household income. NYSOH determines what assistance you qualify for, if any, and then helps you enroll in the right program or plan for you.
The private plans sold through NYSOH are called Qualified Health Plans (QHPs). QHPs are regulated by the Affordable Care Act. That means that if you meet income requirements, you might qualify for premiums subsidies and cost-sharing reductions. It also means that those plans follow all the ACA’s rules. For example, they cover all the health services that the federal Department of Health and Human Services have deemed essential, including prescription drugs, maternity care, and primary care. Over 247,000 people have already purchased QHPs for 2019 this year. The next deadline to do so is January 15, for coverage that starts on February 1.
There has been a lot of news about the federal government loosening the rules around QHPs (some people refer to the QHPs as “Obamacare,” though they are only one part of the ACA). New York State has blocked that from happening for the most part – when you buy a QHP in New York, you know that it meets basic standards for health insurance.
The other plans you can enroll in through NYSOH are public plans that people qualify for based on income. Medicaid covers people with the lowest incomes and has no premium and minimal cost-sharing. The ACA helped New York raise the income limit for Medicaid eligibility and allowed New York to get reimbursed for more of its Medicaid costs. Medicaid covers almost 3.3 million New Yorkers, including working people and those who need long-term care (like elderly people or people with disabilities). The Essential Plan is similar to Medicaid but is a new program created through the Affordable Care Act with different funding sources. It has higher income limits and acts as a buffer between Medicaid eligibility and private plans. It covers people for at most $20 a month with no deductible. There are over 776,000 New Yorkers already enrolled in the Essential Plan. Finally, the New York State of Health can enroll people in Child Health Plus, which in New York covers all children up to 400 percent of the federal poverty level. There are almost 414,000 kids in our Child Health Plus program. Enrollment in Medicaid, the Essential Plan, and Child Health Plus is available year-round.