The New York State Health Benefit Exchange

May 4, 2012 | Appeals | Complex Torts & Product Liability | Health Services

On April 12, 2012, State Governor Andrew M. Cuomo issued an Executive Order to establish the New York State Health Benefit Exchange (the “Exchange”), in conformity with the federal Affordable Care Act.  The Order calls for the establishment of the Exchange within the Department of Health and to be funded entirely with federal funds until January 1, 2015, at which time, the Exchange is expected to be financially self-sustaining. 

The Exchange will be a market place for individuals and small businesses to purchase health insurance coverage.  Specifically, the Exchange will facilitate the purchase and sale of qualified health plans and consumer enrollment in health coverage.  It will also enable eligible small businesses to receive tax credits and individuals to receive premium tax credits and cost-sharing reductions. 

Implementation and development of the Exchange is to be carried out by the Department of Health in conjunction with the Department of Financial Services, as well as other state agencies, to meet the functional requirements as set forth in the Affordable Care Act.  As necessary, the Exchange will enter into agreements with federal, state, and local agencies to carry out its duties and responsibilities, including the establishment of programs to provide information and assist consumers in the enrollment for health insurance coverage.

The Exchange will convene regional advisory committees, constituted by stakeholders such as consumer advocates, small business representatives, health care providers, agents/brokers, insurers, and labor organizations.  Such committees will consider relevant regional factors and public opinion in providing advice and recommendations on the establishment and operation of the Exchange.

Overall, it is anticipated that the Exchange will result in lower premiums for individuals and small businesses, and allow them to purchase health coverage and receive $2.6 billion in federal tax credits and cost-sharing subsidies.  It is estimated that this Exchange will provide access to coverage to nearly 700,000 uninsured New Yorkers.

Reprinted with permission.  All rights reserved.

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