New York health insurance rates were set
early this month for 2015, including rates for
the health benefits exchange (NY State of
Health) established in 2013.
Benjamin M. Lawsky, state superintendent
of financial services, said rates for individuals
will continue to be more than 50 percent lower
than they were prior to the establishment
of the exchange – even before adjusting for
inflation or federal financial assistance that
is available to many consumers purchasing
insurance.
He said a substantial influx of new, previously
uninsured customers has helped drive
down overall premium rates in this market
significantly. Nearly one million New Yorkers
enrolled in individual health insurance coverage
through NY State of Health during its first
open enrollment period, including approximately
370,000 who enrolled in private plans.
Overall, in both the individual and small
group markets, DFS cut by more than half the
average proposed premium rate increases that
health insurers requested for 2015. This action
will save policyholders an estimated $1 billion
next year, according to Lawsky.
“We closely scrutinized the proposed rate
increases insurers requested and reduced
them significantly where appropriate,” he said.
“While we have made substantial progress in
reforming our health care market and holding
down costs, there is much more work ahead.
We will continue to engage with consumer
groups, insurers, providers, and other stakeholders
as we move forward with that effort.”
“New York is continuing to serve as a leader
in implementing health care reform,” said
Donna Frescatore, executive director of NY
State of Health. “The success of our state’s health exchange and commitment to doing
the job right is delivering a dramatic improvement
in the affordability and accessibility of
high-quality health insurance coverage for
New Yorkers.”
Lawsky said on average, insurers requested
a 12.5 percent increase in health insurance
rates for 2015 in the individual market. DFS
reduced that average increase more than in
half to 5.7 percent.
Most of the average increase (4.5 percent)
in individual rates is due to an expected
reduction in a federal reinsurance program
for insurers, which is provided through the
federal Affordable Care Act (ACA). Without
the impact of that ongoing phase out, the average
increase would have been approximately
1.2 percent.
Many New Yorkers meeting certain income
thresholds are also eligible for federal financial
assistance when purchasing coverage on the
NY State of Health, which would lower costs
even further for them, said Lawsky. People
with incomes below 400 percent of the federal
poverty level ($46,680 for individuals
and $95,400 for a family of four), can qualify
for financial assistance that lowers cost of
coverage.
The next New York State of Health open
enrollment period begins on Nov. 15 for coverage
starting on Jan. 1. New Yorkers eligible
for Medicaid and all children can enroll in
coverage through NY State of Health at any
time during the year.
The Small Business Marketplace for employers
with 50 or fewer employees is open to enrollment
throughout the year. For more information
about the NY State of Health exchange, visit,
https://nystateofhealth.ny.gov/.