New York's Health Exchanges and Your Insurance Rate

Thursday, July 18, 2013

Fred Mogul, WNYC health reporter, and Elisabeth Benjamin, vice president of Health Care Initiatives at Community Service Society, talk about the expected drop in prices for individuals buying health insurance in NYS when Obamacare's health exchanges go into effect this fall. 

New Yorkers who have questions about navigating the state's healthcare system can call the Community Health Advocates help-line at 1-888-614-5400.

Comments [14]

Kerrigan from Westchester

I was on a low cost New York State insurance plan that was run through EmblemHealth and was just put on a federal "transition plan" until Obamacare is open for enrollment.

The cost is still low. That is not the problem. It's affordable, but now I can't find a doctor who will take my insurance. In the meantime, I basically pay a monthly fee so that I can refill my prescriptions while paying a deductible that I didn't have before. I’m paying more out of pocket for prescriptions and getting a lot less service.

My fear is that the same will be true once I have to sign up for one of the exchange plans. Either I end up with a plan similar to what I have now (high deductibles) or I pay a much bigger monthly fee. Either way, what does it matter if I can’t find a doctor who will accept my insurance?

Jul. 19 2013 12:48 PM

What about having someone like Marcia Angell, M.D. on?

A single-payer advocate, Dr. Angell has been consistently critical of the Affordable Care Act all along.

"Obamacare is simply incapable of doing what it is supposed to do -- provide nearly universal care at an affordable and sustainable cost.[...]So with all the new dollars flowing into the system and no restraints on the way medicine is practiced, the law is inherently inflationary."


People who engage in /voluntary/ high-risk behavior must be required to cover more of the expenses they incur as a result of such choices. It is simply unjust that others should have to bear the burden of such expenses. There is at least /some/ appreciation of this principle, reflected in policy, when it comes to things like smoking, motorcycle-riding, etc. /Perhaps/ even for inordinately poor diet, sedentariness, obesity, etc., I'm not sure.

But what about the area of high-risk /sexual/ practices and lifestyles? Inordinate promiscuity, of course. But also, specifically, the practice of buggery (anal penetration), an inherently unhygienic, unsafe (pseudo-)sex act which, more than any other, spreads not only HIV/AIDS but a whole host of other serious and even lethal infections as well.*

Policies that make people responsible for the expenses they incur as a direct result of such choices need to be expanded to such areas-- as difficult or politically incorrect doing so (or even the mere /suggestion/ of such) may be.

*That homo- and bi-sexual males are, by FAR, the greatest victims of said act and its centrality in contemporary "gay culture", is a bitter irony that is not at all lost on people like Bill Weintraub, Luke Shelton, Chuck Tarver, Martin Finn and others of the Man2Man Alliance ( ), an organization that is as emphatically pro-/homoerotic/ as they are anti-/buggery/, and Rob McGee, whose blogs include and .

Jul. 18 2013 11:48 AM
Judith from Manhattan

The caller who gave as evidence that the Affordable Care Act will not do anything to reduce health care costs brought up the matter of Medicare Part D (prescription drugs) & the fact that it did nothing to bring down medication costs.

He is evidently unaware that, due to legislators of the same mind, who believe government can never do anything better than the private sector, put it into law that Medicare may not, despite its huge clout in covered lives, negotiate drug prices for its participants en bloc directly with Big Pharma. The plan works by having coverage parceled out/divided up to existing commercial insurance companies. Of course Part D does not help bring down costs. In his 2012 State of the Union address, President Obama mentioned that they would work to repeal that law & unleash Medicare's enormous negotiating power (which is very effective when it comes to hospital costs) but sadly have never heard again of any movement in this direction.

Jul. 18 2013 11:34 AM
Amy from Manhattan

A year & a half ago my health insurance co. raised my monthly premiums to an unaffordable level. I got them down to a more manageable rate by switching to a plan w/higher copays. It was absolutely worth it--I'd have to be going to doctors ~3 times a month for it to cost what the I'm saving on premiums. (I also don't have coverage for physical therapy without a hospital admission, which I'm less happy about.)

Jul. 18 2013 11:15 AM
Mr. Bad from NYC

The affordable car act has no cost controls, only cost shifting to the middle class and working poor. How "progressive".

Jul. 18 2013 10:44 AM
Lisa in Brooklyn

Does the affordable care act mandate that all doctors accept all insurance? Because as it stands now, they are not required to. Many doctors don't even accept Medicare now. I've had a lot of trouble finding doctors who accept my low-end (not big name) insurance. And forget about finding a mental health professional who accepts ANY insurance. Next to impossible. So if we are all compelled to buy insurance, even if it is as lower cost, will that really get us more access to health care? Or is it just a gift to the insurance industry?

Jul. 18 2013 10:41 AM
Mr. Bad from NYC

@ Bobby G from East Village

Yes, you bring up a great point. The main consumers of these individual policies are self employed sole proprietors like yourself. I'm happy to hear your policy costs will come down (not being sarcastic) but these health insurance premiums will still be too expensive for the working poor to afford, even with subsidies. These individual policies will still be hundreds of dollars more than comparable employer policies. These guests are comparing apples to oranges.

The "bronze" level plans which poor people will have to go for offer little or no coverage, it is in fact even worse than walking into the ER for care because now in addition to the high costs, copay's and coinsurance they will have to pay they will also be burdened by unaffordable medical debt where before they could just get charity care for free. Bankruptcy's will skyrocket. How could anyone really believe that a system predicated on private health insurance would be more "affordable"? Medicaid will absorb the truly destitute while the middle class and working poor get the shaft as usual.

Jul. 18 2013 10:40 AM
Nat from NYC

If an employee pays a lot for employer-subsidized health insurance, why shouldn't they be able to leave their employer's program for the exchanges? I'm not convinced, Elizabeth.

Jul. 18 2013 10:40 AM
Joyce from Brooklyn

A few months ago, I was told by Oxford (my provider) that I would not be eligible for any of their policies on the new Exchange — that I would have to go without insurance for 1 year to be eligible. Is this true?

Jul. 18 2013 10:39 AM
Tom from New Jersey

I'm an actuary that prices insurance (though not health insurance). Insurance is priced on risks - if the cost goes down so much, does that mean that insurance companies/medical providers were previously charging too much for those risks? I'm skeptical that a larger pool and competition more than halves premiums.

Jul. 18 2013 10:38 AM
antonio from baySide

How are the exchanges different between the public option...

Jul. 18 2013 10:37 AM
Amy from Manhattan

Robert, this segment is all about what *is* getting done about it & how it *is* going to change.

Jul. 18 2013 10:29 AM
Bobby G from East Village

There are so many self employed sole proprietors, including myself, in this city that have been paying outrageous individual health insurance premiums. Even with the State subsidized Healthy New York Program the monthly payments doubled in five years.

Jul. 18 2013 10:29 AM
Robert from NYC

Here we go again bitching about the high cost of healthcare and nothing getting done about it. It seems that all we do these days in this country is to talk and bitch about everything from food cost to healthcare costs to the cost of everything else everywhere. Yes folks, everything today has high costs. Food, shelter and healthcare are particularly painful because we all are affected by these necessities. But in this free and open market economy everything is and will always be at a high cost because that's just the way it is in a free and open market economy. It's every man and woman and child for him/herself and the survival of the most devious will reap the best benefits. So since we can't really do or don't really want to do anything about it let's talk and bitch about it. I don't really enjoy watching the decline and fall of this American Society but there is a kind of "I told you so" satisfaction I get from it along with nausea and high blood pressure. So go on and complain now about the high cost of healthcare. Entertain me.

Jul. 18 2013 10:09 AM

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