Securing Health Care for Women and Our Families

As health care decision-makers and frequent caregivers for our families, women know how important it is to have health insurance that covers our medical needs and fits our family budgets. But health insurance can be expensive, and the fine print of health insurance policies can be confusing. New Yorks Health Benefits Exchange will offer quality, affordable health coverage for people without insurance and for small businesses seeking to cover their employees.

PROVIDING

BACK-UP

PLAN FOR

FAMILIES THAT LOSE COVERAGE

In a struggling economy, too many working families are losing their health insurance because of layoffs or employer decisions to drop coverage. Because New York businesses are spending roughly 18% of payroll for employee health insurance each year, more and more small businesses are concluding it is simply too expensive to offer coverage. For women, there is an additional threat of losing dependent health insurance coverage through divorce. In 2010, an estimated 14.48% of New York City residents had no private or public health insurance. This percentage was higher in the Bronx (16.3%) and Queens (17.8%). Many of these uninsured New Yorkers were working, but had no employee insurance and were not eligible for public insurance. An estimated 18.45% of employed residents in New York City had no health insurance coverage. 1 This percentage of uninsured working people was even higher in the Bronx (23.5%) and Queens (22.7%). Women and families trying to buy their own health coverage in the individual market find unaffordable premium costs, as much as $12,852 a year for a family of three. 2 The exchange will serve as a safety net in these situations. Individuals and families who do not have employer-based insurance, yet do not qualify for public insurance, will have an opportunity to purchase quality, affordable health care plans in the exchange. Small businesses can also use the exchange to find affordable health plans for their employees.

MAKING

COVERAGE AFFORDABLE

New Yorks health benefits exchange will enable moderate-income individuals and families (who earn up to $43,560 for an individual or $74,120 for a family of three) to receive subsidies in the form of federal tax credits that can be used toward the

cost of buying insurance plans within the exchange. In New York City, 62.4% of families have incomes below $75,000 and could potentially be eligible to receive this assistance with family health insurance costs. In Brooklyn, 67.9% of families could potentially qualify and in the Bronx, 77.3%. 1 Because the exchange will increase access to affordable health insurance, an estimated 1.1 million New Yorkers will gain health care coverage. Across New York City, the exchange would cut the uninsured rate by about 37%.3

HELPING FAMILIES GET

THE

COVERAGE

WE NEED

The Exchange will establish standards for the health plans that will be offered to families and small businesses. All plans must cover at least an Essential Health Benefits package of key services. For women, these benefits will include such preventive services as Pap smears, mammograms, STI screenings, contraceptive services, counseling about domestic violence, and an annual wellwoman visit. Also covered will be pre-natal care, maternity care and breastfeeding support services. As health care decision-makers for our families, women will be thrilled to know that the exchange will offer us easy-to-understand information about our health coverage choices and help in selecting the plan that best fits our families health care needs and budgets. We will be able to use an exchange website to shop for coverage, and a call center to get our questions answered. Navigators will be available to help guide us through the process of using the exchange and selecting a plan. These navigators, which may be community-based organizations, will provide one-on-one support for consumers, helping women and our families compare the costs and benefits of plans sold in the Exchange. Brokers are likely to play this role for the small businesses that will be shopping in the Exchange for employee health insurance plans.

PROTECTING
BUDGETS

FAMILY

Family budgets are being strained by layoffs, salary freezes and rising costs for essentials such as food and gas. Just one indicator of this trend is the rising number of students on free or reduced cost lunch programs at schools. Families need protection from the skyrocketing costs of health care premiums, deductibles and copays.

Because New Yorks Health Benefits Exchange will be acting on behalf of millions of New Yorkers who need health coverage, it will have the potential to get better prices from health insurers who want to sell their plans in the Exchange. Rate increases would be subject to state approval. To learn more, visit www.hcfany.org
1 2

Census Bureau, American Community Survey estimates: http://factfinder.census.gov/ Kaiser Family Foundation, http://www.statehealthfacts.org/profileind.jsp? ind=976&cat=5&rgn=34 3 Impact of Federal Health Reform on New Yorks Uninsured, Urban Institute December 2011