Updated Federal Regulations End Continuous Coverage for Over 9 Million New Yorkers with Public Health Insurance
Eligibility Redeterminations to Resume this Spring for Enrollees in Medicaid, Child Health Plus and the Essential Plan
New York Continues Year-Long Outreach Campaign Educating Consumers About Coming Changes and How to Renew Their Insurance
Marketplace Welcomes 13th Anniversary of Affordable Care Act (ACA) with Record-Breaking Enrollment Numbers, as More New Yorkers Access Health Insurance They Can Afford
ALBANY, N.Y. (March 23, 2023) – The New York State Department of Health today announced that beginning this spring and continuing through spring 2024, more than 9 million New Yorkers enrolled in Medicaid, Child Health Plus and the Essential Plan will need to renew their health insurance. Enrollees in these public health insurance programs have not had to renew their coverage since early 2020 due to the COVID-19 Public Health Emergency (PHE) continuous coverage requirements. However, the December 2022 federal Consolidated Appropriations Act included new rules ending the continuous coverage requirements starting Spring 2023. These new federal rules now require states, including New York State to begin redetermining eligibility for public program enrollees in the Spring of 2023.
“The end of the public health emergency does not mean a downshift in public health,” NY State Medicaid Director Amir Bassiri said. “It is our top priority to reinstate eligibility reviews in a way that to retains coverage for as many enrollees as possible and limits coverage gaps, particularly for vulnerable populations dependent on services. It is the right of every New Yorker to have access to insurance, and we remain committed to keeping this right intact.”
Renewal notices will be sent to enrollees in these programs by NY State of Health, the New York City Human Resources Administration (HRA), and local Departments of Social Services beginning spring 2023, which will include the deadline for an enrollee to take action to renew their insurance or risk having a gap in coverage. Renewal notices will be sent on a rolling basis and renewal deadlines will be based on the enrollees’ enrollment end dates and will range from June 30, 2023, through May 31, 2024. Consumers are encouraged to renew by the 15th of the month.
To prepare for the transition out of the PHE, the Department has spent the past year reviewing federal guidance; developing plans to enhance information technology systems, augmenting resources and staff; engaging a public education and outreach campaign; and collaborating with state and federal government officials, local departments of social services, partners, advocates and other stakeholders to educate New Yorkers about the important changes coming to their insurance programs.
“Eighty-three percent of the population being redetermined are enrolled through NY State of Health, New York’s fully-integrated health plan marketplace,” said NY State of Health Executive Director, Danielle Holahan. “NY State of Health has been working for the past year to educate the public about these changes. We are prepared to assist enrollees in navigating the steps to renew and have systems in place to transition individuals who are no longer Medicaid-eligible into the Essential Plan, Child Health Plus, or a Qualified Health Plan.”
As New York prepares for the transition from the PHE, the availability of affordable coverage has remained critical. PHE related flexibilities as well as enhanced federal tax credits has made coverage even more accessible and affordable helping to cut New York’s uninsured rate in half since the passage of the Affordable Care Act 13 years ago, today.
NY State of Health Enrollment as of Jan 31, 2023:
|
Program Type |
January 2023 Enrollment |
|
Medicaid |
5,204,182 |
|
CHP |
377,598 |
|
QHP |
214,052 |
|
Essential Plan |
1,123,110 |
|
Total |
6,918,942 |
The impact of PHE provisions has been vast, with nearly 50 percent of New York’s population enrolled in public health insurance. The State has made adjustments to ensure as many enrollees as possible retain eligibility. Premium contributions for children with incomes up to 222 percent of the federal poverty level were eliminated in CHP, and the Medicaid income eligibility levels were increased for individuals with disabilities and those over age 65.
The State has also requested permission from the federal government to administratively redetermine eligible individuals with disabilities and those over the age of 65 who have Medicaid through local departments of social services. New York’s Essential Plan for low-income individuals will smooth the transition for New Yorkers who no longer qualify for Medicaid and enhanced federal tax credits will make coverage more affordable for individuals transitioning to a Qualified Health Plan.
Additionally, the State is proposing an expansion of its Essential Plan in January 2024 to make health insurance more affordable for low-to middle- income earners. Essential Plan coverage has no monthly premium or deductible and very low-cost sharing; expanded Essential Plan coverage would have a $15 monthly premium.
New York’s Medicaid program operates in three eligibility systems. Each of these systems has different timing for issuing renewal notices, which will be sent out monthly based on the enrollees’ enrollment end dates.
- NY State of Health, the State’s official health plan Marketplace, processes MAGI-Medicaid cases administered by the State, as well as all eligibility determinations for Child Health Plus and the Essential Plan.
- The New York City Human Resources Administration (HRA) serves New York City counties.
- Local Departments of Social Services encompass all counties outside of New York City.
Notices will include the deadline to renew with first discontinuances of coverage effective for all eligibility systems starting in July 2023.
In an effort to minimize the number of New Yorkers at risk of being disenrolled, the Department of Health has spent the past year engaged in continuous outreach, including a robust public education campaign with paid advertising, option to receive text notifications about renewals, an informational consumer webpage, and an online Communications Tool Kit to be shared with partners, providers, advocates and stakeholders to help educate consumers about these changes.
Tool Kit resources include:
- Communication tools and templates, available in 14 languages, including a poster, fact sheet, infographic, pre-written social media posts and images, ad campaign videos, drop-in articles and drafted email blast messages.
- Infographics describing the renewal process of each eligibility system.
- PHE unwind letter for partners.
- Fact sheets detailing public program enrollment by county and Congressional District.
For more information or questions about eligibility reviews and the renewal process, consumers should reach out to the NY State of Health Customer Service Center at 1-855-355-5777 or to their local Department of Social Services office, or learn more on the NY State of Health website and the Department of Health’s Medicaid website. Both sites are updated regularly.
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Contact: New York State Department of Health
518-474-2043 x. 2