CSS to Help Navigate New Yorkers to Affordable Health Care

David R. Jones, La Nueva Mayoria / The New Majority

The Community Service Society (CSS) was recently selected by the New York State Department of Health to set up a “navigator” network to help New Yorkers and small businesses shop for and enroll in health coverage through the New York Health Benefit Exchange (NYHBE).  The exchange is a central feature of health care reform through the Affordable Care Act (ACA).  Federally subsidized health insurance exchanges, or insurance marketplaces, have been set up in 17 states – including New York - to administer the ACA.  The exchanges will make getting health coverage consumer-friendly for the first time.

New Yorkers will be able to sign up for affordable health insurance under the ACA starting on October 1, 2013, for coverage beginning on January 1, 2014.  If you don’t know where to go to sign up, go to www.communityhealthadvocates.org, the website of Community Health Advocates, the state’s designated consumer assistance program.

When the ACA goes into full effect, 1.1 million New Yorkers are expected to newly gain affordable insurance.  Latino New Yorkers, who historically have had low rates of health insurance and disproportionately high rates of health-related illnesses, especially stand to benefit from the new law.  

The ACA was passed in response to the 47 million people in the United States (2.6 million in New York State) who are uninsured.  The new law will eliminate health-based discrimination by insurance carriers, make health insurance more affordable, and reduce the growth of health care spending.  For those with low- and moderate incomes (earning less than $94,200 for a family of four), there will be financial assistance from the government to help pay for insurance.  People will not be denied health insurance on the basis of a pre-existing condition.

With the ACA in effect, parents can now keep their children on their insurance until age 26. About 160,000 young adults in the state have gotten coverage under this provision.  Lifetime dollar limits on health benefits have been banned, so 6.4 million New Yorkers no longer have to worry about running out of insurance benefits if they get sick.

CSS will partner with 38 community-based organizations and small business-serving groups in 61 of New York’s 62 counties.  The goal is to enroll 55,000 individuals, families, and small businesses and their employees into the exchange each year.

Under the ACA, New York State will receive $2.4 billion a year in federal subsidies to make insurance affordable.  In addition, the state will save $2.3 billion a year in Medicaid costs while expanding the program to cover 80,000 new enrollees.

When New York’s Health Benefit Exchange opens on October 1, consumers will be able to compare health insurance plans, enroll in Medicaid, or apply for subsidies to buy commercial coverage.  Small businesses will be able to apply for $220 million in tax credits to provide insurance to their employees.

Individuals and families that purchase coverage directly through the exchange will see their health costs drop by as much as 66 percent.  For small businesses, the cost to their employees for health insurance may drop by as much as five percent.  Already, the impact of the exchanges has caused several insurers in California and Oregon to lower their rates in order to be competitive. 

Governor Cuomo provided the leadership for health coverage in New York.  When the State Senate refused to set up a state health insurance exchange legislatively, the governor issued an executive order doing so.  Since Governor Cuomo’s executive order, the state has received almost $370 million in federal implementation grants.  New York has also expanded its Medicaid program to ensure that low-income residents can get coverage.

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