One state set to reap some benefits of the Affordable Care Act is New York.  New York state residents will be able to get health insurance coverage thru the health exchanges for half the cost of plans today.  The health exchanges, a key element of the ACA, are set to open in October with coverage beginning in January 2014.  The ACA will require people to obtain insurance coverage in the New Year or pay a penalty. 

The New York rates are the latest to be disclosed as state and the federal government gets ready to enroll residents in state-based exchanges.  While coverage varies in each region, all of the state will see a 50% decrease in premiums.  The cost of a “silver” plan — which covers at least 70% of medical costs, on average will drop to as little as $359 a month for a single adult Manhattan resident according to a rate sheet recently released by state officials.  Right now, the cheapest plan a city resident can buy on the individual market is around $1,000.  Health care costs per capita are about 18% higher in New York than elsewhere in the nation.

Seventeen insurers will offer coverage thru the exchanges, which will come in four tiers.  The bronze plan, the lowest and cheapest, the silver, gold and platinum (the most expensive). Each plan will have a standard set of benefits, allowing people to choose between insurers based on price.

According to state officials, the plans will also differ on the range of doctors and medical facilities included in their networks.  The wide spread decrease in premiums for next year is largely because insurers have to base their 2014 rates on models and not actual costs.  Officials expect the differences to narrow in the future.

The significant decrease in rates in New York will likely not be seen in many other states because New York is one of the few states that already required many of the basic benefits of the ACA.  The state does not allow insurers to reject people because of pre-existing conditions and required every plan to provide a standard set of deductibles, co-pays and benefits, including hospital care, lab tests and prescription drugs.

Only 17,000 New Yorkers buy their own insurance right now, while 2.6 million people lack coverage.  The state is expecting more than 600,000 people to enter the exchanges, with about 70% of them eligible for federal subsidies. 

 

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