DFS Takes Action to Ensure a Continued Healthy and Competitive 2019 New York Health Insurance Market Despite Continued Wrongful Federal Attacks on the Affordable Care Act
In the face of a sustained attack by the federal government on the Affordable Care Act (ACA), Financial Services Superintendent
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Due to the ACA, the impact of the 2019 rate increases will be mitigated by increased federal tax subsidies for some individuals purchasing coverage through the
The main driver of premium rates, as in prior years, is underlying medical costs. For the 2019 individual rates announced today, drug costs account for the largest share of medical expenses (28%), followed by inpatient hospital costs (19%), specialist physician services (11.3%), diagnostic testing/lab/x-ray (10%) and ambulatory surgery (9%).
The ACA required consumers to purchase insurance or pay a penalty unless they qualify for a limited number of exemptions. While the mandate remains in the ACA, the recent federal 2017 Tax Cut and Reform Bill eliminated the individual mandate penalty for not having health insurance effective
Under the leadership of Governor
In addition,
Superintendent
Since the beginning of the Affordable Care Act,
Individual Market
Approximately 330,000 New Yorkers are currently enrolled in an individual commercial plan. DFS reduced insurers' total weighted average increase requested for individuals by 64%, from 24% to 8.6%. These rates will be further reduced for many consumers due to federal tax credits. For example, overall average 2019 cost of coverage for individuals who purchase the second lowest cost silver plans on the
Rates for individuals are more than 55% lower than prior to the establishment of the NY State of Health in 2014, adjusting for inflation but not counting federal financial assistance that the ACA makes available to many consumers purchasing insurance. Under the ACA, financial assistance through federal tax credits for those who qualify will increase in 2019. Households between 200% of the federal poverty level, which is the highest level to qualify for the Essential Plan, and 400% of the federal poverty level (
These rate decisions do not include the Essential Plan, available only through the NY State of Health, which will still have premiums of
Click here to view tables (https://www.dfs.ny.gov/about/press/pr1808031.htm)
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