The Patient Protection and Affordable Care Act (ACA) provides new or expanded affordable coverage options to New Yorkers with incomes below 400% of the Federal Poverty Level (FPL). These coverage options, “Insurance Affordability Programs” (IAPs), include Medicaid, the Children’s Health Insurance Program (CHIP), which in New York State is called Child Health Plus or CHPlus, advance payments of premium tax credits and cost-sharing reductions, and a Basic Health Program (BHP), should the State establish one. In 2014, consumers will be connected to these programs through a streamlined, standardized, consumer-oriented, and technology-enabled eligibility process available through its Medicaid/CHIP programs and new Health Benefit Exchange.

In a report prepared for the Coalition of New York State Health Plans through the support of the New York State Health Foundation, Patricia Boozang and Alice Lam of Manatt Health Solutions explore the challenges New York state policymakers will confront as they seek to implement healthcare reform in a manner that maximizes continuity of insurance coverage for lower-income New Yorkers. After creating an exchange and designing a new eligibility determination system, New York will face the task of enrolling its residents in the affordable coverage option for which they are eligible. In addition, New York faces a major secondary challenge: preventing interruptions of enrollment or coverage as incomes fluctuate (and, thus, eligibility for IAPs potentially changes). The policy brief analyzes these variations, examines barriers to coverage continuity and offers recommendations to minimize coverage losses when changes in eligibility do occur.