IIABNY: New York Health Insurance Exchange Offers Consumers Fewer Options, Less Comprehensive Coverage
IIABNY: New York Health Insurance Exchange Offers Consumers Fewer Options, Less Comprehensive Coverage
Association director Jack Smith tells Senators exchange plans ‘not a viable option’ for customers
New York’s health insurance exchange offers consumers and business owners fewer plan options and narrower choices of health care providers, IIABNY told state senators. Jack Smith, an IIABNY regional director, testified before a joint hearing of the Senate Health and Insurance Committees in Albany.
“Once our agency began helping our customers find coverage, we found that in our service area, the plans offered through the Exchange were simply not a viable option for most of our customers,” said Smith. He is also executive vice-president and owner of William A. Smith & Son Insurance Agency based in Newburgh. “In fact, we have only enrolled one small business through the (Small Business Health Options Program, or SHOP) exchange.”
Many provisions of the federal Patient Protection and Affordable Care Act (ACA), popularly known as “Obamacare,” took effect on Jan. 1, 2014. One of them required every state to have a health insurance exchange. New York’s exchange is formally known as New York State of Health (NYSOH). Smith told the senators that the ACA has hurt consumers, particularly sole proprietor business owners.
“Overall, the ACA has resulted in fewer options for consumers,” he said. “While the essential benefits provided by the ACA are good, the higher deductibles, higher cost sharing, and loss of out of network coverage has diminished the coverage actually provided to consumers … The offerings available to sole proprietors are now limited and generally the overall cost of coverage higher.”
Smith also said that the only exchange-offered options available to consumers buying coverage on their own are health maintenance organization (HMO) plans. These plans do not cover the use of out-of- network health care providers. “The inability to access out of network coverage is an important factor for many families, especially those with children that attend college out of the plan coverage area,” he explained. “If these children become ill while away at college, they would have to travel back to the covered plan service area to obtain coverage.” He also noted that a major hospital in his area is not a participating provider in any plan available through NYSOH.
Smith praised New York Gov. Andrew Cuomo and NYSOH staff for their work in setting up the exchange. However, he noted some implementation problems that occurred. He pointed to the very short timeframe producers had to take the certification training before the October 1 launch of the exchange. He also cited difficulties in accessing the NYSOH Web portal, trouble navigating it, delayed transmission of data to insurance companies, and the absence of a tool to allow producers to easily compare plans.
