(Released January 20, 2011) Policy and Education Fund of New York (PPEF). The report makes numerous recommendations for the state implementation of the new federal law in New York State. The recommendations cover five major areas: 1) consumer-oriented governance; 2) consumer assistance; 3) affordable health insurance rates; 4) consumer rights; and 5) reduction of racial and ethnic disparities in health care. Among the report’s major recommendations are:

  • strong consumer representation on the governing board of the New York exchange, the health insurance “marketplace” that must be created by the state by 2014;
  • aggressive consumer enforcement through a significant increase in penalties that may be recovered by the State Insurance Department against health insurers that violate the new federal law, a state exhange that can exclude health plans that sell lower quality products, and a strong role in enforcement by new Attorney General Eric Schneiderman;
  • a permanent independent consumer assistance office to coordinate community-based organizations across the state to assist consumers with disputes with health insurers, enroll consumers in health insurance, and help consumers select health insurance plans;
  • reform of the health insurance rate regulation system that was reinstituted in New York in 2010 to allow consumers to meaningfully participate in rate proceedings;
  • expansion of consumer rights by allowing consumers harmed by serious violations of health insurance laws to recover their damages in court (known as a “private right of action”); and
  • reduction of health care disparities based on race, ethnicity and other factors: by designating a single state entity to oversee collection of disparities data and to make this information available to the public at no charge through the Internet.

Click here to download the PDF.