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New York State's Leadership in Providing Health Insurance

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Amidst the national controversy over the creation of health insurance exchanges or marketplaces, the launch and early months of New York's official health plan marketplace stand out. Governor Andrew Cuomo and the Departments of Health and Financial Services deserve recognition for an impressive start, even as further refinements are underway.

Generally speaking, implementing a government program as it was intended should not be reason for celebration. But this was an extraordinarily complex challenge with many dimensions: building the site; integrating insurance products; storing and accessing the personal data; managing the transactions; explaining the process to the public; incorporating multiple languages; building public confidence through accuracy and speed; generating usage, and doing it all on a massive scale with aggressive deadlines.

That's why the Citizens Budget Commission recently awarded its 2014 CBC Prize for Public Service Innovation to the New York State Department of Health, the lead agency for the creation of NY State of Health, the state's health plan marketplace. The CBC Prize is awarded annually -- in alternating years to either a New York City or a New York State agency -- to recognize and promote successful innovations in the delivery of public services.

NY State of Health allows New Yorkers to shop, compare, and purchase quality health plans, as well as access federal financial assistance for health insurance. Launched on October 1, 2013, it is a "one-stop-shopping" gateway for New Yorkers to access private insurance coverage, as well as public health insurance options such as Medicaid and Child Health Plus.

As of April 16, 2014, 960,762 residents had enrolled, and more than 1,319,239 had completed the application process -- already significant progress toward the expectation of enrolling 1.1 million New Yorkers by the end of 2016. More than 70 percent of enrolled individuals reported that they did not have insurance at the time they signed up through NY State of Health.

The open enrollment period for individuals ended on March 31, but applications initiated by that time could still be completed thereafter. Coverage starting on January 1, 2015 can be purchased beginning on November 15, 2014.

NY State of Health Customer Service Center representatives have answered more than 1.2 million calls from New Yorkers since the launch of the marketplace, and more than 8,800 specially trained and certified assistors have been available in counties throughout the state to help people apply in person. Navigators who provide in-person assistance to consumers speak 48 languages, and assistance is available through the Customer Service Center in any language. Consumer materials are online in eight languages (English, Spanish, Chinese, French, Haitian Creole, Italian, Korean, and Russian).

Through NY State of Health, individuals and families have been able to purchase coverage at premiums that are 53 percent lower than premiums for comparable coverage in 2013. In addition, individuals and families at or below 400 percent of federal poverty level receive financial assistance in the form of federal tax credits that further reduce the cost of coverage.

Small businesses with 50 or fewer employees can also purchase health insurance through NY State of Health. Enrollment in the small business marketplace is available all year long at www.nystateofhealth.ny.gov. Already 4,000 small businesses across the state have enrolled.

Much more will be learned in coming months about who has enrolled and who has not, and that will provide direction for further improvement. A system as complex as this, in a state as large as New York, will need continuous refinement.

But New York has distinguished itself through the creation of NY State of Health. The marketplace has excelled, despite a very tight timeframe, while other state marketplaces and the federally facilitated one faltered.

That's no small accomplishment -- and one for which the government officials and staff who made it possible deserve public recognition.

Carol Kellermann is President of the Citizens Budget Commission.