Cuomo Takes Steps to Keep New York State Insurers in Individual Market

June 05, 2017 at 11:22 AM
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(Bloomberg) — New York Gov. Andrew Cuomo announced steps on Monday to encourage insurers to keep selling health plans through NY State of Health, the state's Affordable Care Act public exchange, as the companies withdraw from other markets amid uncertainty surrounding the health law.

The state is tying participation in the ACA exchange system to other government contracts. Insurers that leave the individual market would be cut off from participating in other government health programs, including Medicaid, the Children's Health Insurance Program and the Essential Plan, according to a statement from the governor's office.

The Essential Plan, an ACA Basic Health Program plan, offers cheap coverage for low-income people who earn too much to qualify for Medicaid or other programs.

With congressional Republicans working to change the Affordable Care Act, and the Trump administration fomenting uncertainty about some funding for insurers, major national carriers like Aetna Inc. and Humana Inc., as well as smaller regional plans, have quit some states. Those departures have threatened to leave some consumers without any insurance options for 2018, and Republicans have pointed to them as a sign the health law is failing.

While choices vary by county, New York state has more individual insurance options than some other states, with 14 companies offering health plans for 2017. Publicly traded carriers that sell in the state's exchange include Anthem Inc. and UnitedHealth Group Inc. UnitedHealth has largely exited the individual market in other states, while Anthem has indicated it's weighing whether to leave some regions.

The new rule may push insurers to stay in the state's public exchange system, because the other government health programs in the state are far larger.

About 242,000 people have enrolled in individual health plans through the state's exchange, while 665,000 picked Essential Plans.

More than 6 million people are enrolled in Medicaid and CHIP plans in New York state, according to federal data.

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