New York Sets Emergency Rules for Health Insurers

The state has about 242,000 people in private plans sold through the exchange system; 665,000 in Essential Plans, or standardized plans provided by private insurers but set up by the state; and about 6 million in Medicaid and CHIP coverage, according to exchange and federal data.

Cuomo has ordered the state’s Department of Health to bar any company that withdraws from the exchange from participating in the state’s Medicaid, CHIP or Essential Plan programs, in an effort to thwart insurers from leaving the state’s exchange program.

Some hospital and physician groups, including the Greater New York Hospital Association, applauded that directive and others.

Paul Macielak, the president of the New York Health Plan Association, said his group, which represents 29 managed care plans, believes most of the coverage requirements already exist in current laws or regulations.

“We do not understand the ‘emergency’ here” Macielak said.

Macielak also questioned the legality and timing of the directive requiring insurers that want to participate in Medicaid and CHIP to stay in the exchange program.

“In many ways, the governor’s press release has the potential to create more uncertainty for plans than the uncertainty of the proposals being discussed in Washington,” Macielak said.

In related news, the New York Department of Financial Services is reviewing health insurers’ rate filings for 2018. The department asked insurers to provide estimates showing how the elimination of major ACA commercial health insurance requirements and subsidies might affect their rates.

Health insurance companies in New York are asking for an average rate increase of 16.6% for individual coverage in 2018. That’s lower than the 19.3% average increase for 2017 coverage.

Insurers that tried to estimate how full repeal of the Affordable Care Act individual coverage mandate would affect their prices predicted full repeal would increase their rates by an additional 32.6%, department officials said.

— Check out New York Fines Excellus $1M Over Birth Control Claim Denials on ThinkAdvisor.