New York residents can start signing up Wednesday for another year of insurance coverage through the state’s official health plan marketplace, including low-cost options for those who qualify.
The enrollment period for the NY State of Health marketplace will run until Jan. 31, six weeks longer than the federal marketplace’s enrollment period, which the Trump administration opted to end Dec. 15.
And while funds for outreach and advertising were slashed for the federal marketplace, state officials said New York’s expenditures to help people sign up will remain the same, and that premiums, after tax credits, will cost many New York residents less than this year.
Congress tried but failed to repeal the Affordable Care Act this summer. Amid pronouncements that the ACA was “collapsing,” President Donald Trump curtailed the funds for the federal marketplace website, used by residents in states that chose not to create their own marketplaces. Trump also ended cost-sharing reduction (CSR) payments that helped insurance carriers offset costs of the lowered deductibles and copays they must provide to eligible customers. On the federal exchanges, some premiums rose sharply.
State officials are anxious to reassure New York residents that their marketplace is in good shape.
“Amid all the news swirling around like the Affordable Care Act is going away or premiums going up, it’s important we get the message to New Yorkers that the marketplace is open for business,” said Donna Frescature, executive director of NY State of Health. “They have a choice of health plans and for many New Yorkers their premiums will stay about the same or go down in 2018.”
The state approved premium rate increases in August, with a weighted average increase for individual premiums of 14.5 percent that included a 0.6 percent increase to compensate insurers for the loss of the CSR payments.
Twelve companies offer plans on the exchange, including six on Long Island, she said.
Actual premium costs will be stable or drop for people eligible for tax credits (individuals making up to $48,240 and families of four with incomes up to $98,400), according to the health department. A Long Islander making $25,000 a year can buy the most popular silver plan for $80 a month in 2018, compared with $134 a month currently. Those with incomes of between $30,000 and $40,000 will pay about $50 less a month, or more than $600 a year, for the same coverage. A bronze plan, which has higher deductibles and copays but no cost for preventive care, will be free for a person with a $25,000 income.
Only people enrolling in plans through the state marketplace at nystateofhealth.ny.gov can get low-cost plans such as Medicaid or the Essential Plan, or obtain the tax credits and reduced out-of-pocket expenses created under the ACA.
Child Health Plus, low-cost insurance for children whose families make too much to qualify for Medicaid, is also purchased on the marketplace but is in jeopardy because Congress let it expire Sept. 30 despite bipartisan support. Funding in New York may run out in late December if Congress fails to renew it. Frescature said families would be notified of alternatives before funds run out.
“As the fifth open enrollment period begins of the ACA, New York has a leg up on many other states because it runs its own marketplace, and the state and consumers are committed to it,” said Peter Newell, an analyst with the United Hospital Fund, who said New York’s average premiums are among the highest in the nation and its pool of insured among the sickest. “But nonetheless it faces some homegrown and federal challenges in very uncertain times.”
For the next three months, however, 5,500 people certified by the state will begin signing people up at hospitals, social service agencies, and in the community at events at libraries, churches and community centers.
“In New York we have navigators ready, willing and able to assist,” said Janine Logan, a spokeswoman for the Nassau-Suffolk Hospital Council, one of three not-for-profits certified as navigators, or assisters, to help Long Islanders choose a plan and sign up.
On the first day of enrollment, she said, “We’re going to be in Suffolk County at Our Lady of Grace [Catholic Church] in West Babylon at noon, and on Thursday at 4 p.m. we’re at Stony Brook University Hospital level five admitting and at Mercy Medical Center front lobby in Rockville Centre.”
Things You Need to Know
- When to enroll for ACA insurance: Nov. 1, 2017, to Jan. 31, 2018
- Where:https://nystateofhealth.ny.gov/ or 855-355-5777
- To get help in person: Find out at https://info.nystateofhealth.ny.gov/events; http://coverage4healthcare.org/insurance_under_65/ and www.healthsolutions.org/navigator
- What: Health plans offered for Long Islanders: Fidelis, Healthfirst, OSCAR, Empire BCBS, Emblem, United Health Care. All offer bronze, silver, gold and platinum tiers. Most popular is the silver plan, where the cost-sharing reductions are.
- Who: Individual mandate is in effect. If you submit a federal tax return, you must have coverage. The penalty is the greater of $695 per adult, or 2.5 percent of household income, capped at $3,264 per year in 2017.