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Obamacare New York

Updated May 24, 2018

Use the Form Below To Get Actual Updated Price Estimates For 2017 For Obamacare Plans In New York. You can also get pricing information on Obamacare alternatives if you find that the available plans are out of your budget. 

New York is one of a few states that manages its own state-based marketplace exchange for health insurance coverage under the Affordable Care Act. Customers in the State of New York can use the NY State of Health to shop for and enroll in ACA-compliant health plans. A New Yorkian can also use an independent agent, web-broker website or an independent marketplace like this one to shop and compare health insurance plans and to enroll.

Requirement by Law

Despite all of the politics around healthcare reform, the Affordable Care Act is still the law and New Yorkians must get health insurance from their state exchange during the open enrollment period and maintain that coverage for the entire year. If they don't do that in 2018 they will be penalized under the individual mandate. An adult could face a $695 penalty or 2.5 of the household taxable income, whichever is greater. After 2018, the individual mandate will be gone in accordance with the tax bill passed at the end of 2017.

Obamacare Enrollment Options For New York State

New York was one of the few states who saw increased enrollment numbers during this past 2018 open enrollment period with 253,102 total enrollments. During the 2017 open enrollment period, 242,880 people signed up for health insurance using the state exchange, compared to nearly 272,000 in 2016.

While customers in New York can use the federal marketplace site for enrollment, it may be beneficial to shop around using a comparison site like this one. Getting current quotes from multiple carriers can help you find a plan that adequately addresses your needs and fits your budget. Brokers can also help explain your options more clearly.

In 2018, New York enrollees were able to choose from 12 carriers on the exchange, losing Affinity and CareConnect from the previous year.

Carriers Expected To Be Offering Coverage Include:

  • Capital District Physicians’ Health Plan
  • Emblem (Health Insurance Plan of Greater New York)
  • Empire Health Choice HMO
  • Excellus Health Plan
  • Fidelis Care New York
  • Healthfirst PHSP
  • HealthNow New York (BCBS of Western NY and Blue Shield of Northeastern NY)
  • Independent Health Benefits Corporation
  • Metro Plus Health Plan
  • MVP Health Plan
  • Oscar
  • UnitedHealthcare of New York

Plan options from these insurers will vary across the state. Premium rate increases for 2018 will also vary, but the average is about 13.9 percent assuming that cost-sharing reduction payments will not be made and that the individual mandate will not be enforced. If CSR payments are guaranteed, then the weighted average increase will go down among the various insurers.

Cost Assistance For Obamacare In New York 

Lower and middle-income families and individuals can receive subsidies and tax credits to help offset their out-of-pocket costs in the State of New York. Approximately 55 percent of exchange customers in New York qualified for premium subsidies in 2017.

Open enrollment is different for people in state-based exchanges because these states have some flexibility in setting enrollment periods. For 2018, the open enrollment period in New York ran from November 1, 2017 to January 31, 2018. Those who want coverage to start on January 1 needed to enroll by December 15. The 2019 open enrollment period should run for the same period of time - November 1, 2018 to January 31, 2019.

Obamacare in New York in Previous Years

If you live in New York, you have access to a state-run health exchange, known as the New York State of Health. The agency released an annual report illustrating the state’s enrollment breakdown for Affordable Care Act (ACA)-approved plans. As of Feb. 28, 2015, more than 2.1 million New Yorkers had enrolled in a Marketplace plan, compared to 2014’s 960,762 enrollees.

In total, there are currently 16 different carriers that provide individual exchange plans. But for millions of lower-income New Yorkers, a new program, known as the Essential Plan, may dramatically transform the healthcare experience.

The Essential Plan is a Basic Health Plan (BHP), a state-run and generally federally funded plan for lower-income families and individuals. Typically, these are people with incomes from 139 percent to 200 percent of federal poverty level (FPL). But this plan has no deductible and no premium, as long as enrollees’ incomes are no more than 150 percent of the FPL.

While all states can implement the BHP option, as of yet, only New York and Minnesota have received the necessary federal funding. Essential Plan enrollment will begin on Nov. 1, 2015, the first day of the regular Open Enrollment Period (OEP).  Enrollment in the Essential Plan, as well as all other policies, will run through Jan. 31, 2016.

And for those beneficiaries who don’t want to enroll in the Essential Plan, New York offers other healthcare subsidies, as well. Currently, enrollees with incomes between 138 percent and 200 percent of poverty are eligible for premium subsidies and cost-sharing subsidies, but switching to a BHP during the upcoming open enrollment may result in lower premiums and lower cost-sharing.

When considering their 2016 healthcare plans, New York residents should take the time to explore the New York State of Health website. Here, you can receive direct quotes from providers and compare pricing and benefit information, as you make an informed decision.

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