NY State of Health

As I've written about several times before, starting April 1st, New York State expanded their wildly popular Essential Plan program (NY's name for the ACA's Basic Health Plan program) up the household income scale from 200% of the federal poverty level (FPL) to 250% FPL:

On March 1, 2024, the U.S. Department of Health and Human Services (HHS) and U.S. Department of Treasury approved New York's Section 1332 State Innovation Waiver application to expand the Essential Plan.  Section 1332 State Innovation Waivers allow states to pursue innovative strategies for providing residents with access to high quality, affordable health insurance.  The waiver was approved for five years, from 2024 through 2028.

...Key Components of the Waiver

This approved State Innovation waiver expands health insurance and covers health-related social needs, improving health care and advancing health equity.  The waiver includes the following key components: 

via NY State of Health:

Effective January 1, 2025, Waiting Periods Will No Longer Be Permitted for the Majority of Adult Dental Services Offered Through the Marketplace

• New York State Continues to Explore Improvements to Adult Dental Benefits for 2026 and Beyond

ALBANY, N.Y. (April 4, 2024) – The New York State Department of Health, NY State of Health, and the Department of Financial Services announced today that, effective January 1, 2025, there will no longer be waiting periods for the majority of adult dental services for Individual Stand-Alone Dental Plans available to purchase on the Marketplace. This change is the first of a multi-phased initiative to improve dental products and to improve the dental plan shopping experience for consumers. 

via NY State of Health:

Enrollment Remains Open Across All Marketplace Programs for Duration of Public Health Emergency Unwind

Albany, N.Y. (February 28, 2024) – Representatives from NY State of Health, the state’s official health plan Marketplace, will make an appearance at job fairs across the State beginning next month to inform New Yorkers about their options for quality, affordable health insurance. Certified enrollment assistants will be available to help uninsured job seekers find a plan that fits their budget and health needs and guide existing enrollees through the new renewal process to keep their coverage current.

via NY State of Health:

• Certified Enrollment Assistors Visit Colleges Across New York State
• New Yorkers Who Enroll by February 15 Will Have Coverage in Place for March 1

ALBANY, N.Y. (February 9, 2024) – NY State of Health, the state’s official health plan Marketplace, today announced an informational college campaign, with events taking place on campuses throughout New York State. Certified enrollment assistors will be visiting schools to talk to students about affordable, quality health insurance through the Marketplace, and help current enrollees renew their coverage. Enrollment for 2024 coverage is currently open for Medicaid, Essential Plan, Child Health Plus, and Qualified Health Plans (QHP). Consumers who enroll by February 15 will have coverage for March 1.

As I noted last week, while the 2024 ACA Open Enrollment Period ended in most states back on January 15th, and in several more as late as January 31st, there are two remaining states where it's technically still going on: California, which bumped their final Open Enrollment deadline out by an extra 9 days at the last minute on the 31st, and New York, which announced last fall that they're keeping enrollment fully open to anyone all the way out until the end of May, to coincide with the end of the ongoing Medicaid Unwinding process.

Thanks to Louise Norris for catching this one.

This is a bit odd...… earlier today I noted that Covered California is extending their Final 2024 Open enrollment deadline out until January 9th due to a service center issue they had over the past few days. A key thing about this, however, is that they included a formal press release to announce the extension.

By contrast, New York State of Health, also supposed to have a deadline of midnight tonight, just posted the following tweet without any formal press release being emailed or posted on their website. Of this writing there's also no notice posted on the front page website.

Very strange, although perhaps they'll send one out/post a notice tonight or tomorrow morning?

NY State of Health hasn't issued any formal 2024 Open Enrollment Period press releases with hard enrollment data yet, but they have posted this January 2024 Essential Plan and Qualified Health Plan Enrollment by County and Plan report.

Most of the report is devoted to breaking out enrollment in NY's Basic Health Plan (BHP) program, called the Essential Plan in the Empire State, but it also breaks out enrollment in Qualified Health Plans (QHPs) as of January 1st via their ACA exchange platform by county...including statewide summaries at the bottom.

As of January 1st, 2024, NYSoH reports:

• 1,197,534 BHP enrollees
• 276,962 QHP enrollees

I don't remember whether the deadline for January 1st effectuation was 12/15 or 12/31 in New York, but assuming it was 12/31 this means a whopping 32% more people signed up by New Year's Eve than last year at the same point (209,854). If it was 12/15, it's a bit higher (32.6%).

via NY State of Health:

• Enrollees in Public Health Insurance Programs Must Take Steps to Renew their Coverage for 2024

• New Yorkers Shopping for Qualified Health Plans Can Enroll by December 15 for
  Coverage Starting January 1

  ALBANY, N.Y. (December 8, 2023) – NY State of Health, the state's official health plan Marketplace, is working together with food pantries to help New Yorkers fight food insecurity and help them access high-quality, low-cost health insurance for the seventh consecutive holiday season. NY State of Health’s annual open enrollment period for Qualified Health Plans started November 16 and consumers who enroll by December 15 will have health coverage starting January 1, 2024.

via NY State of Health:

• Health Insurance Scams Related to Renewals Are Increasing

• Health Commissioner and Attorney General Offer Tips to Avoid Scams

ALBANY, NY. (November 16, 2023) State Health Commissioner Dr. James McDonald and Attorney General Letitia James today cautioned New Yorkers about health insurance enrollment scams as 2024 enrollment through the NY State of Health is set to begin on November 16.

The NY State of Health, New York’s Health Plan Marketplace, offers one-stop health insurance shopping for both public health programs, Medicaid, Child Health Plus, and the Essential Plan, and commercial health insurance, Qualified Health Plans. Earlier this year, after the pandemic’s continuous coverage rules expired, New York State resumed the practice of reviewing and renewing eligibility for those enrolled in the public health programs. Health insurance scams regarding these renewals are increasing.

Every year I seem to forget that New York State of Health launches their annual ACA Open Enrollment Period two weeks later than every other state for some reason...

• New Yorkers Who Enroll by December 15 Will Have Health Insurance in Place for January 1

• Enhanced Health Insurance Premium Tax Credits Remain Available in 2024

• NY State of Health Makes Available Certified Enrollment Assistors to Offer Free Help, Plan Comparisons , and Cost Estimates to Consumers Across the State

ALBANY, NY. (November 16, 2023) – NY State of Health, the state’s Official Health Plan Marketplace, today announced the beginning of its eleventh annual open enrollment period for health insurance. New Yorkers shopping for coverage through the Marketplace are offered a wide selection of high-quality comprehensive health plans, with the support of certified enrollment assistors to guide them through the enrollment process, establish eligibility, and determine any potential financial assistance. Beginning today, consumers have until December 15, 2023, to renew or enroll in a Qualified Health Plan for health insurance starting January 1, 2024.