About two million New Yorkers have signed up for insurance under theAffordable Care Act, with three out of every four of them poor enough to qualify for Medicaid, according to figures released Wednesday by the Cuomo administration.
While Gov. Andrew M. Cuomo heralded the overall numbers as a sign of the success of the program, having such a large proportion on Medicaid, which is funded by the government, could impose a heavy new burden on public finances.
But insurance experts said they expected the impact of the new Medicaid enrollment to be mitigated by the greater access to health care. In other words, they said, having Medicaid coverage would give people access to primary care that could keep them from developing a chronic disease or becoming catastrophically sick and ultimately costing the system even more.
“Theoretically, could these numbers of people eventually push that Medicaid number up higher? Yes,” James R. Tallon Jr., president of theUnited Hospital Fund, said on Wednesday.
But, he added: “Having most people insured is the key to controlling long-term cost growth because it means you can manage care in a more effective way.”
By and large, experts said, those signing up for private insurance on the state’s Affordable Care Act health exchange are people who were priced out of the market before. The law raised the income ceiling for Medicaid eligibility in New York and other states that accepted the expansion of the program; a family of four can now earn about $33,000 and still qualify. Many people who earn too much for Medicaid can get subsidies to help them buy private insurance.
Though Republicans in Congress have criticized the public costs and tried several times to repeal the law, which was passed in 2010, President Obama has vowed to veto any attempt to overturn it.
A new federal policy expanding the ability of immigrants to remain in the United States may further swell the insurance rolls, Mr. Tallon said. But he said the policy was probably too new to have affected this year’s numbers.
Governor Cuomo also took a positive view, saying in a statement that “these numbers are a testament to our progress in helping those without coverage find a plan that works for them.”
Mr. Cuomo has said, however, that the state needs “a dedicated and sustainable revenue source” to keep the exchange going. In his executive budget, he is proposing a surcharge of up to $25 a year on health insurance premiums for coverage both inside and outside the exchange.
Leslie Moran, senior vice president of the New York Health Plan Association, an insurance industry group, said Wednesday that the surcharge was “a very bad idea.”
“Taxing insurance only makes it more costly and therefore, less affordable,” Ms. Moran said. “If affordable health coverage is the goal here in New York, the new ‘exchange tax’ should be dropped.”
Private coverage has gone up by 133,000 so far this year and Medicaid enrollment by 297,000. About 15 percent of those who bought private coverage last year have not renewed, possibly because they found the premiums too high or they obtained coverage through their employers.
Enrollment is not yet over for the year; the deadline is Feb. 15. Those who do not enroll by that date will have to wait until 2016 for coverage, unless they have experienced a life-changing event, like marriage or the birth of a child.
This is the first year that people who do not have insurance can be penalized for it on their taxes.
Date: February 4, 2015