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New York and the End of Cost-Sharing for Essential Health Plans

Mon, October 16, 2017 10:52 AM | Babette Grey (Administrator)

President Trump's administration announced last week that it will immediately end subsidies that insurance companies and New York State receive to help pay for health care for lower- and middle-income people buying insurance on their own.

New York was one of two states (the other was Minnesota) to implement an optional benefit under the ACA known as the Essential Plan within the NY Health Exchange.  

The Essential Plan offers health insurance with maximum premiums of $20 a month to New Yorkers who earn more than the limit allowed by Medicaid, up to 200 percent of the federal poverty level, or $27,720 for a single person. About 665,000 New Yorkers are enrolled in the Essential Plan.

For New Yorkers on the Essential Plan, the cost-sharing reductions go directly to the state to cover costs. This year the payments for the Essential Plan totaled about $925 million. Those payments will end if there were no more cost-sharing reductions.

For a full Q and A on the issue, see recent TimesUnion news article by Claire Hughes highlighting the impact. 

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NYSSOS serves the interests of New York orthopaedists and their patients by helping to create an optimal practice environment in which to provide quality and efficacious orthopaedic care. 

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