2016-01-27 / Features

Affordable Care Act Sees Massive Signup


Open enrollment to sign up for health coverage under the Affordable Care Act ends January 31 and 11.6 million people have done so nationwide through January 20.

“We’re seeing unprecedented demand for marketplace coverage,” said Secretary of Health and Human Services Sylvia Mathews Burwell, in a January 8 New York Times report. Now in its third year, health insurance coverage in New York under the Affordable Care Act (ACA) is managed by the state.

Managing Executive Director for the Office of Citywide Health Insurance Access at the New York City Human Resources Administration (HRA) Audrey M. Diop gave a presentation on health care access to the Queens Borough Cabinet this month.

HRA assists city residents with enrollment for available plans on the state’s official health plan marketplace, known as New York State of Health, during the open enrollment period that began last year on November 1.

“How do people get covered in New York State?” said Diop, citing the two basic paths, public and private insurance. “Private insurance is obtained from either employers or insurance agents and/or brokers while public insurance comes through an application to the New York State of Health marketplace.”

The New York State of Health marketplace serves mainly individuals under the age of 65. Of the 11.3 million people signed up nationally this year, about three million were 18 to 34 years old, the age group most sought by insurance companies.

Andrew M. Slavitt, the acting administrator for the federal Centers for Medicare and Medicaid Services that runs HealthCare.gov, the federal marketplace, said he expects a rush of younger people to apply in the days left before the January 31 deadline in the January 8 Times report.

Uninsured individuals must pay a penalty to the Internal Revenue Service (IRS). This year the amount is $695 or 2.5 percent of income, whichever is higher, for a single adult individual and $2,000 or 2.5 percent of income, whichever higher, for a family of four.

Exemptions from paying a penalty include if you are uninsured for less than three months, earn too little to pay taxes, cannot find affordable coverage, have a hardship or religious objection, are incarcerated, live outside the US, are undocumented or an American Indian or Alaskan Native.

Individuals may apply for more than one exemption and some exemptions may be time-limited so you should apply as soon as possible if you need one. If your exemption is denied you have 90 days to appeal.

The special enrollment period begins February 1, 2016 and continues through October 31, 2016 for the following qualifying events:

• Getting married

• Entering into a domestic partnership

• Getting pregnant or having a baby

• Changing immigration status

• Moving to New York or from county to county within New York

• Losing your health insurance coverage

The special enrollment periods “are not allowed for people who choose to remain uninsured and then decide they need health insurance when they get sick,” said Kevin J. Counihan, Chief Executive of the federal marketplace HealthCare.gov in a January 19 New York Times report.

For more information and assistance, visit nystateofhelath.ny.gov or call 1-855- 355-5777.

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