October 1 is D-day for New Yorkers to start shopping for affordable health care coverage on the New York Health Benefits Exchange. Some 2.9 million residents are uninsured (out of a population of 19.2 million), and experts and advocates are ramping up to make New York the benchmark state for maximizing health care access for the uninsured, the underinsured, children and even undocumented immigrants.
“We are doing something that very few other states are doing,” Elisabeth Benjamin, vice president of health initiatives at the Community Service Society of New York, told a group of reporters–most from ethnic news organizations–at a roundtable briefing convened by New America Media. “Our exchange truly will be one-stop shopping allowing apples-to-apples comparisons of the variety of health insurance plans available.”
Unlike other states whose exchanges may refer certain applicants to other agencies, New York’s exchange will offer consumers the full menu of available options, from qualified commercial health plans to public assistance programs like CHP (Child Health Plus) and Medicaid. “You go into the New York Exchange and it’s extraordinary,” Benjamim added. “You will come out with coverage, maybe even emergency Medicaid if you’re undocumented.”
New York is one of 19 states that opted to build and design its own exchange instead of relying on the federal government to do so. Because the ACA requires everyone to purchase health insurance, states that are more effective in bringing larger numbers of its residents into coverage will presumably be able to drive down insurance premium costs.
In New York, one study estimates the premium costs for an individual and families could be reduced by as much 66 percent per month. That’s a significant decrease in state where individuals and families pay $1,200 and $3,400 a month respectively, (the latter for a family of four). Individuals and families who do not qualify for Medicaid because their incomes are too high may still be eligible for subsidies to assist them in purchasing health care insurance.
Although enrollment through the exchange does not begin until October 1, the ACA has already yielded tangible benefits. It has allowed some 160,000 young adults, for example, to stay on their parents’ health insurance plans until age 26 — and New York has extended that age to 29. This is helping to reverse a decade long national trend for the 19 to 25 age group, according to data compiled by the Commonwealth Fund: the percentage of young adults who were uninsured fell from 48 percent to 41 percent between 2010 and 2012.
New York is also ahead of the curve in committing funds — some $27 million annually — for ACA’s Navigator program which provides one-on-one counseling and referrals to consumers. By contrast, Ohio, with a much smaller population but a high rate of uninsured, is committing only $2.3 million on a one-time basis.
Sarah Rothstein, assistant director of policy and planning for the New York State Health Benefit Exchange, described how the Navigator program will bridge the state’s language access issues through a multi-layered approach. People who don’t want to enroll over the phone or through the website will be able to get in-person assistance from community based organizations that have been certified as navigators. Though the website for the exchange currently carries instructions in English and Spanish, other languages will be added. Call centers will also commence in October with staff versed in multiple languages including Arabic, Russian, Cantonese, Mandarin, Creole, French, Hindi, Korean, Polish, Punjabi, Urdu and Bengali.
Lorraine Gonzalez-Camastra, director of health policy for the Children’s Defense Fund in New York, emphasized the state’s goal of providing universal coverage for children — “regardless of income or immigration status.” Some 283,746 children in New York are uninsured, of whom 51 percent are minorities, including many noncitizens of immigrant families.
Latinos make up 23 percent — the largest cohort — of the state’s uninsured population overall, noted Becca Telzak, Health Policy Supervisor for Make the Road New York, a grassroots organization. “Imagine not being able to speak the language of the person who’s talking to you,” she said. “It makes it a thousand times harder” to negotiate some of the complexities of selecting the appropriate insurance plan.
Meanwhile Asian Americans are growing rapidly in the state, especially in counties that have otherwise seen declines in the white population. The influx reflects both growing numbers of refugees from Bhutan and Myanmar, and rising birth rates among more established Asian American groups, noted Noilyn Abesamis-Mendoza, health policy director for the Coalition for Asian American Children and Families.
Government agencies and advocacy organizations expect to bring one million New Yorkers under the healthcare insurance umbrella. The open enrollment period begins October 1 and will extend through March 31, 2014 for the first year of implementation. Medicaid eligible persons will be able to enroll at any time throughout the year, as will those with children who qualify for New York’s CHP program. Forty-six percent of those who get public coverage will be non-Hispanic whites, while 28 percent will be Hispanic; 13 percent will be black; and 13 percent will be Asian Americans and others.
The New York Health Benefit Exchange will also run the Small Business Health Options Program (SHOP) which is expected to attract many from immigrant communities who own their own business. SHOP will enable employers to compare the qualified health plans on the exchange and even leverage their purchasing power by partnering with other businesses.
SHOP will be made available to businesses that have 50 employees or less during the first two years of enrollment, 2014 and 2015. Businesses with 100 employees or less will be able to use SHOP in 2016.
From its website to in-person counseling, CDF’s Gonzalez-Camastra said the state has taken great care to ensure that “there is no wrong door” for New Yorkers to obtain accurate guidance.
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