Health Insurance Premiums in New York Face Possible Increase

In New York, health insurance premiums are already among the highest nationwide, and soon, they may rise even further.

The state has a particular health care plan that differs from those in other states, impacting hundreds of thousands of families.

“It gives me a lot of anxiety,” expressed Mike Walsh.

Like many New Yorkers, Walsh juggles multiple part-time freelance jobs, working as a dialect coach.

“My job situation is really feast or famine,” he noted.

His employer does not provide insurance, and he earns too much to qualify for Medicaid. So, he enrolled in New York State’s Essential Plan through the health department.

“The co-pays are pretty low, which is great because it helps manage costs, and you’re guaranteed an appointment as well as your medications,” Walsh explained.

He’s one of the 450,000 subscribers to the Essential Plan who received an email informing him that his coverage would be ending this summer. The reason? At least half of the plan is funded by federal money, which has taken a hit in the recent federal budget cuts, leading to the government shutdown.

“Without that, it would be really tough for me to make a living,” he added.

Walsh is not alone. Alongside those who got the notice, over 700,000 families in the tri-state area have acquired insurance through the Affordable Care Act’s marketplace, and their premium credits are on the verge of expiring.

According to the Empire Public Policy Center, New Jersey has 456,040 people affected, followed by Connecticut with 128,627, and New York with 119,203.

Eyewitness News also spoke with Dr. Donald Morrish, the CEO of Episcopal Health Services, which runs the only hospital on Rockaway Peninsula.

“If we lose the Essential Plan, people are going to start using emergency rooms instead of their primary care providers, and that will be much more costly, which I completely understand,” Dr. Morrish said.

He foresees that losing medical credits and insurance could lead to people postponing treatment, which might increase costs for both patients and hospitals over time.

“Going to the emergency room is significantly more expensive than seeing your primary care doctor,” Dr. Morrish pointed out. This shift could also cause higher expenses for emergency visits.

“Hospitals usually have to cover those costs, turning it into a vicious cycle,” he explained.

As a nonprofit entity, his hospital doesn’t generate profits. With the rising costs of labor, medications, and surgeries, everyone is already stretched thin.

“Therefore, increases in insurance premiums will not only severely impact patients but also the overall healthcare system and workforce,” Dr. Morrish said.

For Walsh, the email mentioned that the state would be in touch within three months about available health options.

“Staying healthy is crucial for me because if I’m not healthy, I can’t work,” he stated.

Currently, 1.6 million individuals are enrolled in New York City’s Essential Plan. A restructuring of the plans is being sought, and if approved, most enrollees might revert to a “basic” plan. However, that would see 450,000 New Yorkers losing their coverage since their incomes don’t meet federal poverty guidelines.