New York

Thanks to Richard Mayhew for the head's up:

ALBANY, N.Y. (AP) — The state's health exchange expects to enroll more than 470,000 New Yorkers in its new low-cost option for coverage this year.

Testifying at an Assembly hearing this week, exchange Executive Director Donna Frescatore said New York chose to participate with the Essential Plan. The plan is an option under the federal Affordable Care Act starting in 2016.

It's aimed at adults who don't qualify for Medicaid but have been unable to afford private coverage.

The Essential Plan has no annual deductible before insurance begins paying medical bills.

Premiums are free for those with incomes at or below 150 percent of the federal poverty level.

At long last, the New York State of Health exchange has released their final 2016 Open Enrollment Period data! (thanks to Dan Goldberg for the heads up)

Actually, two of the data points (private QHPs and BHP enrollment) aren't very different from what I already knew. However, there's some interesting news on the Medicaid & Child Health Plus side:

Rate of Uninsured Drops to Lowest Level in Decades

ALBANY, N.Y. (February 23, 2016) - NY State of Health, the state’s official health plan Marketplace, today announced more than 2.8 million people have signed up for health insurance as of  January 31, 2016, the end of the 2016 open enrollment period.  Since the Marketplace opened in 2013, the number of uninsured New Yorkers has declined by nearly 850,000. According to recently released data by the Centers for Disease Control and Prevention, the rate of uninsured declined from 10 percent to 5 percent between 2013 and September 2015 and is at its lowest level in decades.

On the one hand, I'm kicking myself for not noticing this red flag when the final 2016 Open Enrollment numbers were released last week. On the other hand, I was trying to absorb, analyze and compile a lot of data at the time, so I should cut myself a bit of slack for missing it.

When the numbers were announced, one figure which seemed surprisingly high was that New York (which still hasn't actually released their final numbers yet) apparently enrolled around 400,000 people in their new ACA-created Basic Health Plan (BHP)...and that 300,000 of these folks had supposedly shifted to the BHP program from existing exchange QHP policies.

This did seem surprisingly high to me; I had assumed that instead of NY's QHP total going up around 25% (as I was expecting in most other states), it would stay essentially flat, with the cannibalization by BHPs essentially cancelling out the 100,000 new QHP enrollees I was expecting. 300K making the move was 3x as many as I was expecting. However, in the flurry of other data to crunch, I let this slip by me.

THIS JUST IN...the first official NY State of Health enrollment update (thanks to Dan Goldberg for the tip):

More than 2.7 million New Yorkers currently enrolled in coverage through NY State of Health • New Yorkers must enroll by January 31 for 2016 Coverage

ALBANY, N.Y. (January 25, 2016) – NY State of Health, the State’s official health plan Marketplace, is encouraging uninsured New Yorkers to learn about affordable health coverage options and enroll in a plan by January 31, 2016. To date, more than 2.7 million people are enrolled in health insurance through NY State of Health, including 1.9 million enrolled in Medicaid, and 827,000 enrolled in non-Medicaid coverage. This includes 210,000 children enrolled in Child Health Plus; 260,000 individuals enrolled in a Qualified Health Plan and 356,000 people in the new Essential Plan, a new and more affordable option for lower income New Yorkers.

One of the more obscure provisions of the ACA is the ability/funding for states to set up something called a "Basic Health Plan" for residents who are low income, but not that low income; it's sort of a "Medicaid Plus" program, in a way; here's the Kaiser Family Foundation's explanation:

The Patient Protection and Affordable Care Act (ACA) gives states the option to implement a Basic Health Program (BHP) that covers low-income residents through state-contracting plans outside the health insurance marketplace, rather than qualified health plans (QHPs). In March 2014, the Centers for Medicare & Medicaid Services (CMS) issued final regulations on the requirements for a BHP and the methodology for calculating federal payments to states. States can choose to implement BHP beginning in 2015.

If you look at the State-By-State OE3 enrollment breakdown, you'll notice that there are still 4 blank fields all the way down at the bottom, plus a special note regarding California:

Today's New York Daily News has an article with the following headline:

NYC man sues health care provider Fidelis Care, says Obamacare gave him few options and insurer's site was 'plagued with errors'

Hmmm...OK, he's suing a private insurance corporation, saying that the private insurance corporation's website was error-plagued. So what part does the ACA play in this?

Trying to find a gynecologist for his wife on a New York state health care exchange gave a Manhattan lawyer a major headache.

In papers filed in Manhattan Supreme Court, Robert Neal Halpern says he and his wife were automatically enrolled in Fidelis Care after their previous Affordable Health Care Act insurer, Official Health Plan Marketplace, went belly-up in November.

Breaking...

Deadline extended: enroll by Friday, December 19th for coverage beginning January 1, 2016. Apply now: https://t.co/phogDv2qwK #EnrollNY

— NY State of Health (@NYStateofHealth) December 15, 2015

Here's the official press release:

Press Release: NY State of Health Extends Enrollment Deadline for January 1 Coverage • Dec 15, 2015

New Yorkers Now Have Until December 19 to Enroll for Health Insurance Coverage that Begins January 1

If you take a look at the State-by-State chart, you'll notice that in addition to a few clarifications here and there, there are 5 states (well, 4 states +DC) all the way at the bottom labelled "NO DATA YET".

California insists, just like last year, on doing this weird thing where they release the number of new enrollees who have signed up on a fairly regular basis, but the number of renewals by current enrollees is kept a secret all the way into January. I have no idea why they do that, and it's pretty important given that we're likely talking about somewhere between 1.0 - 1.3 million people here.

On the other hand, at least they've posted data on their new additions. DC, Idaho, Kentucky, New York and Vermont haven't even done that much as of this writing.

The good news (relatively speaking) is that the 200,000-odd New Yorkers currently enrolled in about-to-be-defunct Health Republic NY Co-Op policies have been given an extra 15 days to find a new insurance provider (11/30 instead of 11/15), and that those who don't do in time will be automatically enrolled in a temporary (1-month only) policy with someone else to at least ensure coverage to tide them over through January. The temporary policy may or may not include their preferred doctors/hospitals, but it's better than having no coverage at all during the December gap period, anyway.

The bad news is that the hospitals & doctors who have been treating these folks until now may find themselves getting stiffed by the Co-Op's middle man, MagnaCare:

Things have been changing rapidly in the ongoing Health Republic of New York saga, and as recently as last night each development seemed to make the situation worse...but a few hours ago, Politco New York reporter Dan Goldberg posted a new story which indicates that the powers that be finally have some positive news:

In an effort to head off a potential health insurance disaster, state officials on Sunday announced a series of steps to protect roughly 200,000 customers who are set to lose their health coverage, and promised to investigate the company behind the crisis.

...And those were just the customers who were aware of the change. No one could say for certain how many were unaware they were about to lose their coverage, and other insurers operating on the exchange expressed concern that the customers most likely to pick a new plan were the ones most likely to be sick, a scenario of adverse selection that few companies were prepared to handle.

IMPORTANT DISCLAIMER: I COULD BE COMPLETELY WRONG ABOUT THIS OPTION.

Just this morning I posted some significant updates in the ongoing, increasingly messy saga of Health Republic of New York, one of the ACA-created Co-Ops which is being shut down due to severe financial issues (partly due to the Risk Corridor Massacre debacle, but other reasons as well).

Once again, the short version is:

  • Most of the Co-Ops which are being shut down are at least able to cover their policies through the end of December, giving their current enrollees plenty of time to shop around and switch to a different insurance carrier. This was supposed to be the case for Health Republic of NY as well.
  • However, on October 30th, there was a surprise announcement by the NY Dept. of Financial Services (which includes insurance regulation) that instead of December 31st, the HRoNY policies are being yanked effective November 30th. Furthermore, current enrollees have only until November 15th to find a replacement to tide them over for December.
  • While one month may not sound like a big deal, it's a huge problem for at least some of the 200,000-odd people currently enrolled via HRoNY (note: I thought this number was down to 166K, but may be mistaken about the figure).
  • It's a major problem for some enrollees who are undergoing chemotherapy, for instance, or have other recurring medical services/treatments (many of which are expensive) which can't be "paused" for 31 days.

I wrote a couple of posts last week about the ongoing Health Republic of New York Co-Op meltdown, which has quickly gone from being just-another-Co-Op-closure to a complete disaster for up to 166,000 New York residents, primarily because unlike the other Co-Ops which are at least covering their existing enrollees through the end of December, Health Republic is now having the plug pulled out at the end of November, which gives current enrollees just 8 days to scramble to find new coverage for the last month of 2015.

This was made worse by the fact that the November 30 cut-off wasn't even announced until October 30, and even then, the powers that be in the NY Dept. of Insurance, NY State of Health exchange and Health Republic itself didn't appear to treat this development with any particular sense of urgency. I mean yes, they posted notices about it and supposedly sent out letters to all 166,000 people, but an awful lot of those people didn't appear to have received those notices as of a few days ago. Hell, until a day or two ago the NY State of Health website didn't even have anything posted about the 11/30 cut-off at all.

Well, I've been screaming bloody murder about the situation, as have others, and it seems to be getting some butts moving...but I'm not sure how helpful any of it will be.

First up: Dan Goldberg, a very good reporter for Politico New York, posted a big story about the mess on Thursday which no doubt forced some action:

IMPORTANT: If you're enrolled via Health Republic of New York and have questions about your situation, call this hotline: 855-329-8899

I don't know who's to blame for this. It could be the management of the about-to-be-defunct Health Republic of NY CO-OP. It could be someone at the NY State of Health ACA exchange. It could be someone at the NY Dept. of Financial Services. Perhaps it's all three.

What I do know is that this situation, which was already unacceptable several days ago...

Thanks to "Intheknow" from the comments for the heads up on this:

NYDFS, NYSOH, CMS ANNOUNCE ADDITIONAL ACTIONS REGARDING HEALTH REPUBLIC INSURANCE OF NEW YORK

The New York State Department of Financial Services (NYDFS), the New York State of Health Marketplace  (NYSOH), and the Centers for Medicare and Medicaid Services (CMS) today announced additional actions regarding Health Republic Insurance of New York (“Health Republic”) and a transition plan for Health Republic customers.

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