The Coverage and Cost Effects of Implementation of the Affordable Care Act in New York State

The Patient Protection and Affordable Care Act of 2010 (ACA) provides states with the opportunity to develop health benefit exchanges – structured marketplaces for the purchase of health insurance coverage by small employers and individual purchasers. If New York State elects to do so, the law provides an array of design choices to the states in an effort to allow the exchanges to reflect varying preferences across the country. All health benefit exchanges must adhere to minimum federal standards, but there is considerable room within those standards for states to make a variety of policy choices. This analysis delineates the cost and coverage implications of a standard implementation of the ACA in New York compared to the no reform case, along with the differential effects of a number of alternative design options. This analysis, based upon the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM), is intended to provide analytic support to the state’s policymakers as they assess the options available to them for implementing federal health care reform. We quantify the coverage and cost implications of the various reform options for consumers, employers, and government. The results provided in this report should not be taken to suggest any preference for one policy option over another and are merely intended to provide information on the tradeoffs of different approaches. On February 2, 2012, the NYS Health Benefit Exchange convened a stakeholder meeting to present the results of this model. Meeting materials and the full Urban Institute report are attached.