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Stakeholders

New York values consulting with a wide range of stakeholders in the planning and implementation of the Exchange. Exchange stakeholders include consumer advocates, health plans, small business, agents and brokers, health care providers, health policy experts, members of Tribal Nations and others. The State has convened meetings with large groups of these stakeholders to dicsuss a variety of topics, including Exchange design options and results of consultant studies and reports. The New York Health Benefit Exchange has established five Regional Advisory Committees pursuant to Governor Cuomo's Executive Order No. 42 to provide advice and make recommendations on the establishment and operation of the Exchange, including recommendations about relevant regional factors. The five Committees represent the following regions of the state: Western NY, Central NY/Finger Lakes, Capital District/Mid-Hudson/Northern NY, New York City/Metro, Long Island. Each Committee is comprised of representatives of the Exchange stakeholder sectors.

FAQs for Stakeholders

Will implementing health care reform overall cost New York taxpayers a lot of money?

No. In fact, New York’s Division of Budget estimates significant savings to New York State – $18 billion over 10 years – as a result of health care reform. Similarly, the Urban Institute estimates annual state savings of $2.3 billion when reform is fully implemented. These savings are largely due to enhanced federal financing of certain Medicaid enrollees. Under the ACA, New York was one of seven “expansion states” that will receive 90% federal financing on all childless adults that were covered by Medicaid prior to the ACA. Because New York has been paying 50 percent of the costs for 800,000 childless adult Medicaid enrollees, the State will realize substantial savings when the federal government increases its contribution.

What are essential health benefits?

The Affordable Care Act requires qualified health plans sold through the Exchange and most health plans sold outside of the Exchange in the individual and small group markets to provide health benefits in 10 different coverage areas.

Will New York have to pay for the cost of state mandated insurance benefits not included in the essential benefits issued by the Secretary of Health and Human Services?

Guidance issued by HHS on December 16, 2011 gives New York the flexibility to select the benchmark plan for essential benefits for calendar years 2014 and 2015. As clarified in additional guidance issued by HHS on February 17, 2012, as long as New York selects a benchmark plan that includes state mandated benefits, there is no cost to the State for those benefits. The Secretary of HHS will reassess the essential benefits for calendar year 2016 and beyond. In the event that the 2016 benchmark does not include a state mandated benefit, the federal government cannot seek recovery from the state for 2014 and 2015 for the cost of that benefit, but the State will be responsible for the cost of that benefit moving forward.
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News & Events

May 21, 2013
New York Health Benefit Exchange Regional Advisory Committee Meetings: May 2013
May 20, 2013
Now available: Newsletter Brief

Resources

May 30, 2013
Characteristics of Nonelderly New Yorkers Likely to Enroll in the Health Insurance Exchanges Under the Affordable Care Act
May 30, 2013
Uninsured New Yorkers After Full Implementation of the ACA: Source of Health Insurance Coverage by Individual Characteristics and Sub-State Geographic Area
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What Steps do I Need to Take?

Many resources are available to learn more about what New York is doing to develop the Exchange.  We encourage you to become involved through future events.

Key Dates

December 14, 2012
NYS receives conditional approval of Blueprint application from HHS

October 1, 2013
Exchange begins accepting insurance coverage applications

January 1, 2014
Exchange coverage becomes effective

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