New United Hospital Fund Report Says Enrollment Dropping, Rates Rising, and Risk Score Highest in Nation
Enrollment in New York State’s small group insurance market has declined sharply since 2007, average premiums were the second highest in the nation in 2016, and New York’s small group risk pool was the “sickest” among all states that year, according to a HealthWatch report from United Hospital Fund (UHF) released today.
The report, New York’s Small Group Market Isn’t Feeling Well – and a Trump Administration Proposal May Make Things Worse, also found that upcoming federal regulations expected from the Trump administration could undermine longstanding state efforts to preserve the stability of the small group market. The regulations are expected to make it easier for entities to form Association Health Plans (AHPs), under which multiple small groups would be bundled together and issued cheaper out-of-state or self-funded coverage exempt from New York oversight, benefit requirements, consumer protections, and rating rules.
According to the report, enrollment in New York’s small group market dropped from 1.7 million enrollees in 2007 to 1.1 million in 2016, in part because of declining offer rates by small employers, likely fueled by rising premiums. Based on data collected as part of the federal risk adjustment program, average monthly small group premiums in New York for 2016 ($600) rose 39 percent over 2014 levels, and were 35 percent higher than the national average—making New York the second costliest state after Alaska.
One factor that could be driving those higher premiums is the declining health status of the small group market risk pool; New York’s risk score of 1.774 was the highest in the nation in 2016, and well above the national average of 1.324...