Federal changes and state options

Some changes have taken place at the federal level, affecting the entire nation, and other changes were left up to the states.

For example, all states will make available federal tax credits and cost-sharing subsidies, but states will have the option to provide this financial assistance through a federally or state operated exchange.

On April 1, 2012, Governor Andrew Cuomo issued an Executive Order creating a state operated exchange for New York, now known as New York State of Health: The Official Health Plan Marketplace (“The Marketplace”). Though not without its challenges, the Marketplace has been one of the most effective exchanges across the country. So far, more than 2 million New Yorkers, most of whom were previously uninsured, have enrolled in public or private insurance coverage through the Marketplace.

New York has furthered its reputation as a national leader for expanded insurance access by electing to offer a Basic Health Program (BHP). The BHP is an option available to states under the ACA. New York will call its BHP, theEssential Plan — which will provide affordable health insurance coverage to New Yorkers who earn too much to qualify for Medicaid, but struggle to afford private health insurance even with the financial assistance available on the Marketplace. New York is just one of two states to take up this option.

CDF-NY leads a consumer advocate workgroup, along with the Empire Justice Center that has been working with the state to ensure that the Essential Plan meets the needs of un- and under-insured New Yorkers.