Healthy NY closing its rolls; scared of potential Supreme Court ruling? (38061)

A decade-long health insurance program for individuals and small businesses in New York State can’t admit new enrollees because of financial issues.

Pointing to rising health care costs, flat funding and a high numbers of enrollees, Healthy NY recently announced it was clamping down on admitting new enrollees into its standard plan because it can’t financially support them at the moment.

Currently, Healthy NY receives $160 million annually to cover a portion of claims costs for 178,000 enrollees.

The Community Service Society of New York, a policy organization that fights for the rights of the poor, isn’t happy about the new policy and believes it will do damage to an already struggling New York underclass.

“Limiting the Healthy NY program, which is only open to low-income New Yorkers, to a high deductible plan is simply untenable for enrollees,” said Elisabeth R. Benjamin, vice president of health initiatives for the Community Service Society of New York, in a statement to the AmNews.

“For example, a family of three must earn less than $48,000 to qualify,” she said. “But if that same family has a serious medical need, they will have to spend half their monthly income to meet the $2,400 deductible.”

“The only viable solution to New York’s health insurance crisis is for the state to move quickly with implementing the new federal health reform law by setting up a New York Health Insurance Exchange, which will bring down prices by 70 percent for working families and 20 percent for small businesses,” said Benjamin.

But a spokesperson at New York State’s Department of Finances told the AmNews that rumors of Healthy NY potentially closing is a little farfetched, and that the change is for their own good.

“It is not accurate to say that the program is closed,” said David Neustadt, deputy superintendent for public affairs at the Department of Financial Services. “Healthy NY is a state-subsidized health insurance for low-income individuals, families and small employers. The way it works is that the state pays for costs above a certain level, which keeps premiums low.”

Neustadt said that the state’s support for the program hasn’t stopped, they’re just adjusting to outside forces.

“As costs have increased, there would have been very sharp, significant increases in the costs of coverage to those already in the program,” said Neustadt. “The decision was made to protect those already in the program. New enrollees can still access coverage, but with a higher deductible.”

One can point directly to Washington, D.C., when trying to explain Healthy NY’s current situation. With President Barack Obama’s Affordable Care Act being debated in the Supreme Court, programs around the country like Healthy NY are holding off on spending and taking a wait and see approach to health care. But how will the DFS solve problems in the meantime?

“This problem will be solved by the health insurance exchange under federal health reform, where people now enrolled in Healthy NY or eligible for it would have access to affordable health insurance with federal subsidies,” said Neustadt.