September 17, 2018 News

The Essential Plan: A Health Care Success in NYS

From skyrocketing costs to lack of transparency, it’s easy to identify the problems plaguing today’s health care system. With all the negative news out there, it’s important to celebrate the positive. Here in New York, the Essential Plan has become a shining star and proven its ability to provide high-quality, affordable health care coverage to hundreds of thousands of vulnerable state residents.

Authorized as part of the Affordable Care Act, the Essential Plan (EP) is available to low-income New Yorkers who don’t qualify for Medicaid or Child Health Plus. New York is one of two states in the nation that took advantage of federal dollars to create what’s called a Basic Health Plan, which offers an affordable option for consumers earning below 200 percent of the federal poverty level (about $50,000 for a family of four). Here in New York, the Basic Health Plan is called the Essential Plan.

If you’re not familiar with the EP, here’s how it works.

The EP is available to New York residents between the ages of 19 – 64 who meet the below income requirements.

Depending on income levels, residents pay between $0-20 per person/month for coverage that includes the following benefits:

And best of all, the Essential Plan has no deductibles.

Since its launch in 2015, 730,000 New Yorkers have enrolled in the EP, which has played a major role in reducing the state’s uninsured rate from 10 to 5 percent. Despite that success, the program’s future was recently called into question when federal officials announced plans to cut funding for Basic Health Plans. Much to New York’s delight, that funding has since been restored, and CDPHP and other health plans will be offering the product in 2019.

While the future of federal funding for Basic Health Plans is uncertain, CDPHP applauds the efforts of state health officials for creating this valuable health care option, and encourages federal lawmakers to continue supporting this vital program.

John D. Bennett, MD, FACC, FACP
About Author

Dr. Bennett was named president and CEO of CDPHP in 2008, after serving as chairman of the board since 2003, vice chairman since 1999, and board member since 1996. Prior to working at CDPHP, Dr. Bennett served as chief of the division of cardiology at Albany Memorial Hospital, was a member of Northeast Health Systems’ board of directors, and chaired the department of medicine. Dr. Bennett also served as CEO of Prime Care Physicians, PPLC, where he practiced cardiology with Albany Associates in Cardiology. Dr. Bennett chairs the board of directors for the Albany-Colonie Regional Chamber of Commerce and the Healthcare Information Xchange of New York (Hixny). In addition, he is a member of the boards of the Alliance of Community Health Plans, America’s Health Insurance Plans, Colonie Senior Service Centers, the American Red Cross of Northeastern New York, the Center for Economic Growth, New York eHealth Collaborative (NYeC), and the Palace Theatre. Dr. Bennett earned his medical degree from SUNY Downstate Medical Center, Brooklyn, and a bachelor’s degree from Rensselaer Polytechnic Institute. He completed his residency in internal medicine as well as a fellowship in cardiovascular disease at Albany Medical Center. Currently, he is a Fellow of the American College of Cardiology and the American College of Physicians. Dr. Bennett is board certified by the National Board of Medical Examiners and the American Board of Internal Medicine, with subspecialties in internal medicine and cardiology.

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