New York moves to shore up ACA protections, prod insurers to stay in state's exchange

In a move that other liberal states may look to emulate, New York’s governor has issued emergency regulations aimed at keeping certain Affordable Care Act provisions intact even if Congress repeals the law.

The measures, which Gov. Andrew Cuomo announced Monday, will:

  • Require insurers that operate on the state’s insurance exchange to sell plans that offer the 10 essential health benefits as outlined by the ACA
  • Ban such insurers from “discriminating” against customers based on pre-existing conditions, age or gender
  • Prevent insurers that drop out of the state’s exchange from participating in Medicaid, New York’s health plan for children, or its “Essential Plan”
  • Direct state agencies and authorities to ban insurers who withdraw from the state exchange from contracting with the state
  • Safeguard access to reproductive health services and cost-free contraception

“These aggressive actions will make certain that no matter what happens in Congress, the people of New York will not have to worry about losing access to the quality medical care they need and deserve,” Cuomo said in his announcement.

Under the healthcare bill passed by the House, states would have the option of waiving the ACA’s essential health benefits requirement, as well as the “community rating” provision, which currently bans insurers from charging higher individual market premiums based on health status.

New York would not be likely to apply for such a waiver, but its new measures still send a message that it is solidly in support of the ACA’s consumer protections, Kaiser Family Foundation Senior Vice President Larry Levitt told The New York Times.

Other like-minded states could also follow New York’s lead by tying ACA exchange participation to Medicaid contracts—which could significantly affect insurers’ choices to leave or stay in the market, Thomas Carroll, an analyst with Stifel Financial Corp., told The Wall Street Journal.

“The potential for Medicaid contracts now and in the future creates strong leverage,” he said.

But when it comes to ensuring access to cost-free birth control with or without the ACA, New York already has company. Four states have had laws since 2014 that are similar to or even go beyond the ACA’s contraceptive coverage mandates, and Democratic legislators in several other states are considering similar actions in the wake of recent ACA repeal efforts.