New York Affordable Care Act




New York Affordable Care Act Guide

In this informative article, you will learn about the Affordable Care Act health care reform laws in New York.  You will learn how the new health care reform law, Affordable Care Act, also known as Obamacare or ACA, impacts you as a citizen of the state.  Learn how to sign-up for New York Affordable Care Act, the Affordable Care Act penalty, and subsidies.

What is New York Affordable Care Act?

Affordable Care Act, also know as ObamaCare or Health Care Reform, was signed into law in March 2010.  There are four main goals of the Affordable Care Act:

  1. Expanding Health Care Insurance Coverage
  2. Providing New Consumer Insurance Protections
  3. Offering New Insurance Choices via Marketplace Exchanges
  4. Making Health Insurance more affordable

When can I apply for Affordable Care Act New York?

You can only apply for New York Affordable Care Act during Open Enrollment.  The open enrollment for the 2015-2016 year starts from November 1, 2015, and ends on January 31, 2016.

If you qualify for New York Medicaid health insurance, then you can sign-up Medicaid anytime of the year.

If there are life-changing events, then you can apply for Affordable Care Act Special Enrollment Period.

When is New York Affordable Care Act deadline?

The NY Affordable Care Act Open Enrollment is only open for three months.  There are many Important dates around the end of the year for New York Affordable Care Act:

  • December 15, 2015: Last day to enroll in or change plans for new coverage to start January 1, 2016
  • January 1, 2016: 2016 coverage starts for those who enroll or change plans by Dec. 15.
  • January 15, 2016: Last day to enroll in or change plans for new coverage to start Feb. 1, 2016
  • January 31, 2016: 2016 Open Enrollment ends. Enrollments or changes between January 16 and January 31 take effect March 1, 2016.

How do I apply for Affordable Care Act New York (NY ACA)?

New York Affordable Care Act Health Insurance Marketplace is run by NYS State. Click on NY Health Benefit Exchange to access New York Affordable Care Act Marketplace.  You can preview the different insurance plans and see participating doctors before selecting the final health insurance plan.

How much is Affordable Care Act New York?

The cost of New York Affordable Care Act health insurance depends on the metal plan you choose and the number of people in the household.

State Year Avg. Monthly Silver Plan (before Tax Credits) US Average
New York 2015 $372 $268

There are four different health insurance plans within the New York Obamacare Marketplace.  All of the plans cover the Essential Health Benefits.  The metal plans represent the various levels of coverage you receive and what the plan pays on average.  The plan levels DO NOT represent the quality of the health coverage/doctors you receive.

  • Bronze Plan: The plan pays 60% of the cost, you pay 40% of the cost
  • Silver Plan: The plan pays 70% of the cost, you pay 30% of the cost
  • Gold Plan: The plan pays 80% of the cost, you pay 20% of the cost
  • Platinum Plan: The plan pays 90% of the cost, you pay 10% of the cost

Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.

How much is New York Affordable Care Act Penalty?

The penalty (or also called individual shared responsibility payment) is calculated in two ways.

For 2016 year, the ACA penalty is as follows:

  1. By percentage of income (2.5% of household income or maximum of National Average Bronze plan premium)
  2. By number of people in the household ($695 per adult, $347.50 per child or maximum $2085)

You’ll pay whichever penalty is higher.

How much are New York Affordable Care Act Subsidies? What are the requirements?

If your gross income is between 133% to 400% of the Federal Poverty Level, you can qualify for Affordable Care Act Subsidies if you purchased the health insurance from the Federal/State Marketplace.  Affordable Care Act Subsidies are also called, “Premium Tax Credits or PTC.”  If you income is above 400% of the Federal Poverty Level, you do not qualify for any Affordable Care Act Premium Subsidy.

ACA subsidy lowers your premium – the amount you pay each month to your insurance plan. The amount of your ACA Subsidy depends on the estimated household income that you put on your ACA Marketplace application.

Affordable Care Act - Federal Poverty Level
Federal Poverty Level Insurance Premium After PTC Subsidy
Up to 133% FPL 2% of income
133-150% FPL 3%-4% of income
150-2000% FPL 4%-6.3% of income
200-250% FPL 6.3%-8.05% of income
250-300% FPL 8.05%-9.5% of income
300-400% FPL 9.5 of income
Over 400% No Government Subsidy

Do I need to get Affordable Care Act New York?

Yes, every individual in New York needs to have health insurance.  One of the hallmarks of the Affordable Care Act health care reform law is the Individual Mandate.  The Individual Mandate of Affordable Care Act health care law requires US Citizens and legal residents to enroll in a health insurance plan or pay a penalty.

You can choose not to have health insurance, but you will have to pay the penalty in addition to the hospitals/doctors medical fee if you do get sick.

You might be able to qualify for health coverage exemptions and be waived from paying the Affordable Care Act penalty.

What is the Requirement for Affordable Care Act New York?

To qualify for New York Affordable Care Act, you must meet the following requirements:

  • Must live in New York
  • Must be a US citizen, national, or lawfully present immigrant
  • Cannot be currently incarcerated (be in jailed)
  • Have a valid Social Security Number

Medicaid Expansion Relating to Affordable Care Act New York

New York expanded the Medicaid program.

New York Affordable Care Act Frequently Asked Questions:

  1. Who runs the Affordable Care Act New York Marketplace? New York
  2. Where can I sign up for Affordable Care Act New York? Click here
  3. How much is health insurance premium for New York Affordable Care Act? It depends on your income and the number of household/family.
  4. Which insurance companies are offering Affordable Care Act Plans in the state of New York? Click here to see the insurance companies

Click here for more Frequently Asked Questions on ACA / Affordable Care Act.

For additional Information on New York Affordable Care Act / Obamacare:

New York Department of Health
Toll-Free: (855)-355-5777
Website: NY Health Benefit Exchange

Federal HealthCare.Gov Marketplace
Toll-Free: 1-800-318-2596
Website: HealthCare.gov

New York five largest cities in terms of population: New York (Manhattan, Brooklyn, Queens, Bronx, Staten Island), Buffalo, Rochester, Yonkers, and Syracuse.