Just over 1 million people did not have health insurance in New York in 2019, per data from the Kaiser Family Foundation (KFF). That amounts to about 5.3% of the state’s population. Of the people without health insurance, KFF also found in 2021 that nearly 390,000 of them qualify for marketplace coverage.
Under the Affordable Care Act (ACA), marketplace plans must cover pre-existing conditions and 10 essential health benefits. These benefits include things like preventive care, prescription drugs and mental health care, among others. ACA plans also must include subsidies for people who qualify.
Most people qualify for these tax subsidies, aka advance premium tax credits, which help lower the cost of health insurance for people whose incomes fall between 100% and 400% of the federal poverty level.
KFF estimates that of the people without health insurance in New York who could get a marketplace plan, around 7% of them could get a bronze plan for free thanks to tax credits.
When Kaiser Family Foundation calculated average monthly premiums among bronze, silver and gold plans in New York for 2021, they found that the average for lowest cost premiums in these categories were $430 a month for bronze, $588 for silver and $709 for gold.
These averages don’t take into account any tax subsidies that might be available based on income.
It’s also worth pointing out that New York is among the states with its own health insurance exchange. If you think you qualify for a premium subsidy, your best option for saving money would be to find a plan using the state marketplace at NYStateOfHealth.NY.gov.
Using info from our own marketplace, we estimate that a 40-year-old in Rochester who earns $37,000 a year could find a bronze plan for just under $384 a month. That does not include subsidies.
Cost depends on where you live, as does the plan options available to you. There are at least 12 insurers offering marketplace health insurance in New York in 2021. Among them are Oscar, UnitedHealthcare, Centene, Anthem, and Excellus BlueCross BlueShield.
Sources
Kaiser Family Foundation, “Health Insurance Coverage of the Total Population”
Kaiser Family Foundation, “Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach” (January 27, 2021)
Kaiser Family Foundation, “Average Marketplace Premiums by Metal Tier, 2018-2021”
Kaiser Family Foundation, “Insurer Participation on the ACA Marketplaces, 2014-2021” (November 23, 2020)