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Despite uncertainty, NY health plan marketplace continues enrollment

Karen Shakerdge/WXXI

While the New York state health exchange fields its busiest enrollment period yet, uncertainty looms.

A repeal of the Affordable Care Act, without significant replacement, could cost 2.7 million New Yorkers their health insurance, and the state $3.7 billion, according to an estimation released by Gov. Andrew Cuomo's office.

“We believe that the stakes here in New York are dramatic -- for consumers, for our health care delivery system and for our state budget as well,” says Donna Frescatore, executive director of NY State of Health, New York's official health plan marketplace.

Losing ‘momentum,’ is one of Frescatore’s main concerns. Between 2013 and 2015, the uninsured rate in New York folded in half, from 10 to 5 percent, according to the state’s health department.

“We talk to moms who are concerned because their children have pre-existing conditions and they're afraid coverage might no longer be available. We talk to self-employed New Yorkers who fear that the premiums could increase to the 2013 levels -- over $1,000 a month for an individual policy,” Frescatore says.

Without financial support from the federal government and mechanisms that increase risk pools, premiums may increase. Options may become reminiscent of health insurance plans as they were in pre-Affordable Care Act New York.

“New York had a number of very strong consumer protections in place before the Affordable Care Act, including guaranteed issue. People could get insurance regardless of whether or not they had a medical condition or illness, as well as other consumer protections. We'll maintain those protections,” says Frescatore.

But no insurance requirements or financial assistance, she adds, made plans ‘just out of reach.’

For now, the health exchange continues outreach to enroll consumers and reassures that, at least as far as they know, policies won’t be disrupted throughout 2017.

“At this point, without knowing more details about repeal or replacement, what we're really focused on is getting people coverage,” Frescatore says. 

The enrollment period ends on January 31st.

Karen Shakerdge covers health for WXXI News. She has spent the past decade asking people questions about their lives, as a documentary film producer, oral historian and now radio reporter.