The President's Corner
Reforming the Individual Insurance Market
Currently some 2.5 million New Yorkers are without health insurance. As the State’s economic crisis worsens, the number of New Yorkers losing their jobs and employer-sponsored insurance is growing by the day. On top of the surge in unemployment, there are signs that a growing number of employers are trying to stem losses by cutting back on employee health plans and reducing or eliminating health benefits for retirees.
These troubling trends are the new reality for too many New Yorkers who must turn to the individual insurance market to replace the coverage they lost. Unfortunately, many of there are few options to provide them with the coverage they need at a cost they can afford. Over the past decade, the cost of insurance premiums has skyrocketed, with some families in Manhattan paying as much as $4,300 a month for a family coverage plan. As a result, enrollment in the individual insurance market has plummeted from some 111,000 members in 2000 to 41,000 in 2008.
Reversing this trend and reforming the market so that more individuals have access to plans is a complex process. NYSHealth has worked to catalyze efforts to address the issues around insurance coverage in New York, committing its assets to initiatives across the State to reduce health care costs and improve care. Our grantees are testing ideas for expanding health insurance coverage among small employers, sole proprietors, and self-employed individuals. We have seen some success in impacting this issue; recently, one grantee launched a new insurance provider to cover New York’s freelance workers.
Large-scale reform will require a collaborative effort between the State, health care providers, insurers, and employers. This month, two of the State’s leading health insurance providers, Empire BlueCross BlueShield and UnitedHealthcare, took a major presented their recommendations for solving the problems at NYSHealth’s conference, “Reforming New York’s Individual Health Insurance Market.” Empire BlueCross BlueShield recommended a package of reforms—including a merger of the individual, small-group, and Healthy NY markets—and estimated it would reduce the cost of individual coverage by 30%. UnitedHealthcare also proposed a multi-step reform process that included transferring current individual market enrollees to vendors that participate in the New York State Health Insurance Plan, which serves employees of the State and local governments. Under its plan, United Healthcare estimated individual insurance premiums would fall by 17%, without impacting taxpayers or the small group market.
Both of these recommendations are indicative of the kind of wide-ranging reform that is necessary to allow the millions of New Yorkers who are today turning to the individual market to find and afford the coverage they need.
