Healthy NY to only offer High Deductible Plans

Starting January 1, 2012, the state’s public health insurance program, Healthy NY, will only allow new members to enroll in a high-deductible plan option. Healthy NY covers low-income residents and small businesses.

This change for new members is almost certain to result in an enrollment drop in the program at a time when the state and the federal government are trying to increase the ranks of the insured. The state has not increased Healthy NY funding – about $160 million – for the past three years despite increases in both enrollment and claims. It also did not increase the stop-loss funding in the 2011-12 budget and has had to prorate stop-loss distributions to health plans for the past two years. This year Healthy NY’s stop-loss fund is inadequate to cover the higher claims generated by the program’s comprehensive benefit products.

The state believes that the high-deductible plan option will trigger enough of an enrollment drop to make the stop-loss funds go further.

Source: Aetna, Health Care Reform Updates