Earlier today I noted that New York has officially implemented their expansion of the Essential Plan, their branding of the ACA-funded Basic Health Plan (BHP) program that currently covers 1.2 million New Yorkers, from residents earning under 200% of the Federal Poverty Level up to those earning as much as 250% FPL.
In doing so, around 100,000 additional people are now enrolled in the BHP program, with roughly 62,000 of them now saving an average $4,700/year versus the ACA exchange plans they were previously enrolled in, plus another ~32,000 who I presume are completely new to either program.
New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves 1.2 million New Yorkers, or over 4x as many residents as ACA exchange plans do.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves 1.2 million New Yorkers, or over 4x as many residents as ACA exchange plans do.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.
In Oregon, Democrats passed a bill in March to establish a basic health program, the details of which are being ironed out by a task force that began meeting this week. In Kentucky, Republicans approved $4.5 million in state funds this spring to set up a basic health program, which was signed into law by the state’s Democratic governor. An estimated 85,000 Oregonians and at least 37,000 Kentuckians will be eligible to enroll in the plans as soon as next year.
New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.
Nearly Three Quarters of New Yorkers Enrolled in Medicaid, Child Health Plus or the Essential Plan Have Renewed Their Coverage by the June Deadline; Renewal Strategies Are Working; Others Still Have Time to Act
New York Outperforming National Average as Reported by KFF
Monthly Dashboard Tracks Renewal Status, Demographics, and State Program Transitions During Public Health Emergency Unwind
ALBANY, N.Y. (July 18, 2023) – The New York State Department of Health today released the first issue of New York’s Public Health Emergency Unwind Dashboard, a monthly report reflecting data on renewal status, demographics, and program transitions for public health insurance enrollees, which shows renewal outreach strategies are working. The report indicates that roughly 72 percent of New Yorkers enrolled in Medicaid, Child Health Plus or the Essential Plan renewed their coverage before the June deadline to re-enroll and those who haven’t still have time to act to avoid potential lapses in coverage. As reported by KFF, the national renewal rate for states reporting data is 59 percent.
As I wrote about back in March and updated in May, New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.
New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over eleven times as many people as Minnesota's "MinnesotaCare" program does (around 1.1 million vs. 100K). Part of this is obviously due to New York having a larger population, but that's only part of it (NY has 19.84M residents, just 3.5x higher than MN's 5.71M).
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
NEW YORK – New York Attorney General Letitia James and Acting Department of Health (DOH) Commissioner Dr. James McDonald today warned New Yorkers about a new scam targeting New Yorkers enrolled in public health insurance programs and provided important tips to protect consumers. For the first time since March 2020, people enrolled in Medicaid, Child Health Plus and the Essential Plan will have to renew their health insurance coverage. Attorney General James and Acting Commissioner Dr. McDonald are urging New Yorkers to be vigilant in light of reports of scammers deceptively calling people and asking them to pay hundreds of dollars to maintain their health insurance.
“It is despicable that scammers are trying to exploit New Yorkers’ need for quality health insurance and uncertainty over ongoing Medicaid coverage,” said Attorney General James. “The best tool consumers and families have to combat scams is knowledge, and that is why I am committed to raising this issue. I urge everyone to follow our important tips, and anyone impacted by this scam to contact my office immediately.”
