In March, the state finalized a contract with the Urban Institute (UI) to model out various proposals for health insurace reform in order to provide quantitative analyses on the cost and coverage of various proposals.  The state has recently publicized the instructions given to the UI in order to guide the modeling process, and has opened them to public comment.

A rough summary of the Partnership for Coverage modeling instructions is as follows:

The UI is asked to evaluate the following four proposals:

1.  Single-payer Medicare for all

2.  NY Health Plus (Gottfried proposal) to automatically enroll all NYS residents in Family Health Plus (FHP) and a fee-for-service product (with an option for private employers to keep offering private insurance as well)

3.   Combined public-private reforms with various parts to be separately evaluated:

• Simplification and expansion of public programs & federal match for the Child Health Plus expansion to 400% of FPL.
• Market reforms, including a merger of the individual and small group markets, establishment of an insurance exchange
• Public program buy-in option
• Premium support mechanisms
• State-funded stop-loss/reinsurance pools: (1) for individual and small group products; (2) public insurance buy-in.
• Individual mandate
• Employer health care contribution of 6% of payroll tax for: (1) all employers and workers; (2) employers with >25 employees only; and (3) with an exemption for part-time workers

4.  A Freedom plan with: high-deductible plans and HSAs; a Healthy NY expansion  to 300% FPL with a  full buy-in option thereafter; fully funding the stop-loss pool for the direct-pay market or adding an additional stop-loss layer to the direct-pay market for 90% of claims over $500K; elimination of certain state insurance mandates; lowering regulatory requirements and community rating, and tax credits and more stop-loss assistance to health plans.

? The UI must include the following basic assumptions: (1) the target pop. is all NYS residents; (2) the FHP benefit package with full mental health parity is to be modeled for all the “comprehensive” proposals, (3)  cost for each proposal in year 1, 5, and 10 must be determined; (4) no financing or cost-containment ideas will be modeled at this point.

Comments must be recieved by July 21, 2008 and may be submitted in written form to: partnership4coverage@health.state.ny.us.

To view the full modeling instructions, click here: Modeling Instructions

Or view the the state’s website at: http://www.health.state.ny.us/press/releases/2008/2008-06-30_public_comment_invited_for_expansion_of_health_coverage.htm