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Connecting Consumers to Coverage: The Role of Navigators & Consumer Assistance Programs in Implementing Health Reform in New York

September 22, 2011

Prepared by:  Trilby de Jung, Empire Justice Center, Carrie Travy & Elisabeth R. Benjamin, Community Service Society

New York has the historic opportunity to successfully link its consumers and small businesses with health coverage as it implements the new Federal health reform law, the Affordable Care Act (ACA). The ACA promises to provide coverage to 32 million Americans and help bring down the cost of coverage for millions of others. Individuals will be mandated to have coverage and employers will either have additional coverage incentives or responsibilities, depending on the number of people they employ. Enrollment systems in each state will have to be brought to scale in relatively little time to prepare for the surge of new consumers.

Recognizing this enrollment challenge, the ACA requires that each state either establish its own state-based health insurance exchange or default to a Federal exchange by 2014. The exchanges will facilitate individual enrollment in public coverage and affordable commercial coverage. Low- and middle-income consumers who do not qualify for public coverage will receive subsidies to purchase private insurance. Additionally, small businesses will be able to purchase coverage for their employees through the exchange. While the details have yet to be settled upon, a broad consensus has emerged that New York will opt to establish its own exchange, which is expected to enroll as many as 1.2 million—out of a total 2.6 million uninsured—New Yorkers.

Support for this work was provided by the New York State Health Foundation.

 

Download the PDF: Connecting Consumers to Coverage

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