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September 12, 2013 12:00 AM

New York unlikely to see insurance expansion, study says

Rachel Landen
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    A report released Thursday by the Center for Studying Health System Change suggests that New York state, particularly Long Island, will not see much in the way of health insurance expansion in the coming months and years.

    According to “Long Island Follows Bumpy New York Road to National Health Reform,” (PDF) part of that is because New York already has a generous Medicaid program, and Long Island also is one of the most affluent communities in the state, with a high rate of privately insured residents. The report is one of a series of reports by the center looking at the impact of healthcare reform in particular communities around the country.

    The 2014 insurance premiums that have been released in New York are lower than what was originally anticipated and do fall in line with those of other states, there remains doubt about their sustainability. Rates for individual coverage under a bronze-level policy were from $285 to $548 a month when they were released in July of this year. That's down from the $1,001 to $3,319 monthly range for products in the existing nongroup market. But the plans are not exactly the same, and their financial viability also depends largely on the ability to attract young and healthy enrollees to the new market.

    The market is also subject to already limited and declining commercial competition. Oxford Health Plan is in almost sole control of the small-group market, though the Medicaid managed-care market is thriving and competitive. But uncertainty surrounds the challenges of going up against commercial plans and entering an entirely new arena.

    Researchers' findings were based on their examination of the commercial and Medicaid insurance markets in the region and interviews with local healthcare leaders in 2012-13. Long Island is only one of eight metropolitan areas that the center's researchers are studying. Other locations include Baltimore; Denver; Minneapolis-St. Paul; Portland, Ore.; Birmingham, Ala.; Richmond, Va.; and Albuquerque, N.M.

    Follow Rachel Landen on Twitter: @MHrlanden

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