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Obamacare collapse? Not in New York based on record enrollment for 2019: What to know

Lawmakers are currently debating Cuomo's plan for codifying key Obamacare provisions and state regulatory protections into law, including a ban on insurance limitations for pre-existing conditions.

David Robinson
Rockland/Westchester Journal News
  • A record 4.76 million New Yorkers enrolled in health coverage for 2019, up 435,000 from last year.
  • About 8.4 million Americans enrolled in the federal program based on the latest count.
  • State regulators approved ACA health plan rates to individuals an average increase of 8.6 percent
  • Rates will increase on average 3.8 percent for people who get insurance through small-group plans

A record 4.76 million New Yorkers enrolled in health coverage for this year through the state's Affordable Care Act, also known as Obamacare.

The tally, up 435,000 from last year, comes as other states struggled to sustain Obamacare enrollment amid legal and political battles threatening the federal law's future.

Further, New York's strong 2019 showing solidified Gov. Andrew Cuomo's political push to protect the Obamacare marketplace in New York, called NY State of Health, as well as insurance coverage standards for pre-existing conditions.

Health care career specialist Maribel Alonso, right, meets with Jeanette Vazquez of Hillcrest at the Rockland Community College Career Center in Haverstraw Oct. 23, 2018. Vazquez entered the health care industry about a year ago and is now looking to advance her career from caregiver to nursing assistant.

"Despite the continued uncertainty at the federal level, New Yorkers were undeterred this open enrollment period," said NY State of Health Executive Director Donna Frescatore.

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More than 3.2 million people enrolled in Medicaid through the marketplace, while about 1.5 million got its key non-Medicaid coverage through Qualified Health Plans, the Essential Plan and Child Health Plus. The enrollment deadline was Jan. 31.

"Covering more than 4.7 million people is truly a milestone, and we will continue our commitment to bring affordable, comprehensive coverage to New Yorkers," Frescatore said.

State lawmakers are currently debating Cuomo's plan for codifying key Obamacare provisions and state regulatory protections into state law.

It included the ban on insurance limitations for pre-existing conditions, as well as the requirement that all insurance policies sold in New York cover the 10 essential benefits defined in the Affordable Care Act.

State lawmakers are currently debating Gov. Andrew Cuomo's plan for codifying key Obamacare provisions and state regulatory protections into state law.

The politically charged effort unfolded after a Texas judge cast doubt over the millions of New Yorkers’ health coverage connected to Obamacare.

The federal judge ruled the law and its individual mandate, which required Americans to get health insurance, were unconstitutional. While the ruling could reduce coverage in New York in the future, experts said it doesn't impact the coverage for 2019.

Democrats in Congress have also ramped up their defense of Obamacare, one of their first actions after midterm elections in which they won the House after pounding away on the issue of health care, USA TODAY reported.

Democrats authorized House attorneys to oppose a challenge to the Affordable Care Act by Republican attorneys general involved in the Texas case.

National issue

Yet, enrollment in the federal Obamacare marketplaces in many states has declined amid reduced outreach and uncertainty, according to federal data.

About 8.4 million Americans enrolled in the federal program based on the latest count earlier this month

By comparison, 8.7 million people had enrolled at the same time last year. Final numbers will be released in March.

Federal officials described the enrollment as remarkably steady and suggested the strengthening economy and job market may be reducing the need and demand for subsidized health coverage.

They noted the expansion of Virginia’s Medicaid population also potentially reduced the national pool of non-Medicaid enrollees by about 100,000.

Still, the Trump administration slashed millions of dollars in federal funding from a key Affordable Care Act outreach program that helps people sign up for health insurance, USA TODAY reported.

The federal agency that oversees the navigator program said that up to $10 million was available for outreach organizations in 34 states that used the federal marketplace.

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In contrast, New York's Affordable Care Act program planned to spend $14 million on advertising and marketing for the 2019 open enrollment, up from $11 million the prior period.

State government also planned to spend about $27 million on navigators in local communities who assist people through the 2019 enrollment. It spent the same amount last period.

New York Obamacare numbers

Some of the following numbers also told a big part of the Obamacare story in New York.

  • Total enrollment: 4,767,624
  • Of that, 86 percent returned from last year and 14 percent were new
  • Medicaid through the marketplace: 3,287,846
  • Non-Medicaid program enrollment: 1,479,778

The crucial enrollment in the non-Medicaid programs suggested New Yorkers responded to regulators' push to reduce cost.

In its sixth year, state regulators approved ACA health plan rates that will increase costs to individuals by an average of 8.6 percent, which was 64 percent less than what insurance companies sought

Rates will increase on average 3.8 percent for people who get their insurance through small-group plans provided by their employers who have up to 100 employees.

But the actual amount paid by consumers depends on a variety of factors, such as the extent of coverage they choose and eligibility for government subsidies and tax credits.

For example, the Essential Plan for lower income New Yorkers will continue to be offered at no cost or a cost of $20 per person per month depending on income, state officials said.

New Yorkers can still enroll in a Qualified Health Plan if they experience a qualifying life event, such as having a baby, getting married, moving to a new area or losing other health coverage. Enrollment in Medicaid, Essential Plan and Child Health Plus is open all year.

More information about special enrollment can be found on the program's website.