Today, April 12, 2012, Andrew Cuomo, Governor of New York State, issued an Executive Order (EO) establishing a statewide health insurance exchange. This action punctuates an over year-long debate in the state over how to authorize the creation of this new marketplace under the federal health reform law. The EO places the exchange inside the state Department of Health, which is charged with working with the state Department of Financial Services to take “all necessary steps to effectuate the Exchange, and expedite its ability to perform those functions necessary to carry out the requirements and serve the goals of the Affordable Care Act.” Regional advisory committees are another hallmark of the EO. These deliberative bodies, consisting of consumer representatives, small business representatives, health care providers, agents, brokers, insurers, labor organizations, and other stakeholders, will make recommendations – especially through their geographically distinct lenses – on the establishment and operation of the exchange.
Under the Affordable Care Act (the federal health reform law), each state must establish a statewide health insurance exchange by January 1, 2014. These new marketplaces within the broader health insurance market will facilitate enrollment into coverage for individuals and employees of participating small businesses. The federal government will fund completely the development and design of state exchanges, until 2015, when these entities must be financially self-sustaining. Estimates from the Urban Institute, in a study commissioned by New York State, note that the advent of the statewide exchange will spur reductions in health insurance premiums. Individuals are estimated to see their costs drop by 66 percent, and small businesses are expected to see premium relief of 22 percent. New York State has the option to open the exchange to large employers (firms with 100+ employees) beginning in 2017.