Affordable Care Act Outreach

More than 2 million New Yorkers have enrolled in coverage. Nearly 90 percent of enrollees were uninsured at the time they applied for coverage. Many of these consumers enrolled in Medicaid because of increased eligibility and simplified enrollment, and many others have access to affordable private coverage through subsidies now available on the state health insurance exchange, known as New York State of Health: The Official Health Plan Marketplace (The Marketplace).

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.

Supreme Court Rulings

When the Supreme Court released their ruling on the Affordable Care Act on June 28, 2012, the justices largely upheld most of the law.

The Supreme Court ruled that the individual mandate is constitutional due to Congress’s power to tax. The Court did, however, make the Medicaid expansion a choice for states. To date, only about half of the states have chosen to expand Medicaid. In states that have not expanded Medicaid, many low-income residents are stuck without affordable coverage options.

More recently, in June of 2015, the Supreme Court once again ruled on the constitutionality of the Affordable Care Act. This time, the Court focused on just one sentence of the law. Those who filed the lawsuit believed that a literal reading of the law suggested that the federal government did not have the authority to offer subsidies through federally-operated exchanges. While New York uses a state-operated exchange and would not be spared from potential negative consequences, consumers in states with federal exchanges could have lost access to financial assistance if the Court ruled in favor of those who filed the suit.

Thankfully, the Court acted to protect health insurance marketplaces and the consumers that receive assistance to pay for health insurance by ruling against those who filed the suit. The ruling further established the Affordable Care Act as the law of the land.

Funding health reform and financial impacts

A common question is – “What will health care reform cost?”

What will it cost consumers, the state governments, the federal government and all other parties impacted by health care reform? According to the Congressional Budget Office, health reform will slow the growth of health care costs and is estimated to reduce the deficit $143 billion by 2019.

For more information about the costs of health reform visit

Affordable Care Act Toolkit

This toolkit was designed for community-based workers in New York State. While all of the information provided here applies to New York State residents, some of the information applies to other states as well. This toolkit is intended to give a comprehensive overview of several important changes under health reform, focusing on how children and families will benefit from these changes. The one-pagers in this toolkit can be used as reference guides or distributed as handouts. Each one-pager covers a different topic with one side providing basic information about the topic and the other side listing Frequently Asked Questions and Answers.

Download the Toolkit