Affordable Care: Act One

iStock_000019472466Medium - webOn October 1, the nation’s Affordable Care Act (ACA) officially launched its initial phase – admittedly with some fits and starts – to enroll millions of uninsured Americans. While the majority of ACA news coverage has focused on the new insurance exchanges, one of the most promising aspects of the system relates to its treatment of Medicaid, the government program for low-income individuals who cannot afford health insurance.

On this front, New York State is leading the way. We are one of the 24 states to have taken advantage of the federal option to significantly expand Medicaid eligibility. Our State will now provide coverage with no premium and modest co-pays to individuals and families earning up to 138% of the poverty level – up from the former cut off of 100% for most people. This is a meaningful jump from $23,550 to $32,500 for a family of four. The federal government will pay for this expansion through 2016, and no less than 90 percent of costs in later years. In addition, people with incomes up to 400% of the poverty level who buy health insurance through the new Health Insurance Marketplace will receive premium subsidies on a sliding scale.

It is not surprising that New York State is taking full advantage of what the ACA has to offer: for over ten years, under consecutive administrations, the state has been a pioneer in eliminating barriers to health care coverage by streamlining eligibility criteria, eliminating unnecessary burdens such as proof of income and asset testing, and simplifying the application process. In fact, the ACA builds on many of these innovative previous reforms, and also helps New York implement its long-planned online Medicaid application system.

New York State has stepped up to the plate to help vulnerable populations get off the ranks of the uninsured, improving their health and the fiscal health of the state. Unfortunately, there are 26 other states in our nation that continue to trap their poor and low-income citizens in a limbo where they earn too much to qualify for Medicaid and too little to receive ACA subsidies.

There are an estimated 3 million uninsured New Yorkers who can potentially benefit from the ACA. The key provisions of the Act will take effect on January 1, 2014. Beginning now and into 2014, advocates for the poor and near poor must work together to make sure people are aware of the new law, informed of their options and enrolled in a plan. [Some tools to help understand and calculate subsidies are available here.] The Affordable Care Act is not a perfect law, and there will no doubt be difficulties ahead, and continuing inequities. But for now, let’s salute the ACA as a huge step forward for millions of people too long denied access to affordable health insurance.

Blog Post by Yisroel Schulman
President & Attorney-in-Charge

One thought on “Affordable Care: Act One

  1. I’m curious about your take on one quirk of NYS implementation of the health care exchange. It is very easy to create an id and to log in. But, if you actually want to see what the site has to offer, you have to provide a large amount of information, including social security number. The FAQ on the site addresses this by saying that the application cannot be processed without a SSN. But, not everyone coming to the site will be actually applying for insurance. In some cases, people might want to decide if the tax penalty is better than the cost of insurance. And in some cases, people may be coming to see how the cost of insurance compares to what they are now paying at their place of employment. I could, in fact, think of other reasons why people just want to “shop” for the moment.

    Many of these people would be reluctant, I think, to share this level of information for the ability to simply shop. So, it seems to me that it’s a bit of a barrier to accessing the health care exchange. And, while I don’t believe that the decision to collect all of this data was made as a means to intimidate people into purchasing insurance (I have seen this claim), I do know people who would be intimidated by these requirements. And, let’s be honest – What are the odds that someone might decide to use this information to start going after people who have not signed up?

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