全球智库信息集成服务系统

The elimination of the individual mandate penalty is likely to have unique impacts on New York

• Two features make the nongroup health insurance market in New York unique: (1) New York has full community rating, requiring insurers to charge all adults purchasing nongroup plans the same premiums regardless of age or tobacco use status, and (2) New York is one of two states that uses an option under the Affordable Care Act (ACA) to offer a Basic Health Program, called the Essential Plan (EP) in New York, to provide continuous health insurance coverage for low-income residents.
• These two features make New York's nongroup health insurance market particularly susceptible to adverse selection — whereby unsubsidized young, healthy individuals leave the market in much higher numbers than their older, sicker counterparts, leading to higher premiums — when the individual mandate penalty is removed in 2019.
• In 2019, elimination of the individual mandate penalty in New York will lead to a 23–25 percent increase in premiums in the nongroup market and a 37 percent reduction in enrollment in the nongroup market.
• If the EP were not contributing to New York's susceptibility to adverse selection, premiums would increase by 7–10 percent in 2019.