Eligibility for New York's Essential Plan changes this year. Here's what health care advocates want you to know.
Health insurance is getting more expensive across the Tri-State Area. In New York, 140,000 people saw their premiums spike after the Affordable Care Act's enhanced tax credits expired at the end of last year.
But health care advocates say a bigger change is coming this summer that'll drive up costs for hundreds of thousands more.
As many as 450,000 New Yorkers stand to lose EP coverage
The confusion comes as the state restructures a key health care program.
New York's Essential Plan, or EP, provides zero-premium coverage to 1.7 million low-income residents, including 16.4% of Queens residents, 12.9% of Brooklyn residents, and 12.7% of Bronx residents. The EP is for people who don't get insurance through work and don't qualify for Medicaid.
"So it's an excellent insurance offer for people who are eligible," said health care advocate Mia Wagner, with the Community Service Society of New York.
But eligibility is changing. Starting July 1, as many as 450,000 New Yorkers will lose EP coverage and be forced into marketplace plans.
Wagner said the program's income limit is being lowered from 250% of the federal poverty level to 200% after temporary federal funding expired.
"It's just gonna be a really difficult time for consumers," she said. "There's so many moving parts."
The state is trying to limit the damage as a result of the federal cuts, and 1.3 million New Yorkers will be able to stay on the EP.
What Essential Plan enrollees can do now before eligibility changes
Here's what impacted EP enrollees can do right now.
First, update your New York State of Health account. Make sure your income, household size and contact info are up to date.
Next, be on the lookout for notices about potential coverage changes. You want to start shopping for options on the ACA marketplace early.
Finally, and most importantly, don't go at it alone. Wagner says groups like Community Health Advocates can help you understand options, compare costs and enroll in the right plan.
"I think the biggest thing is people don't know about consumer assistance programs," Wagner said. "That these programs are free and they're out there and people are trained as experts, ready to help you navigate your options."
The CBS News New York Investigates team is tracking how rising health insurance costs are impacting families. If you want to share your experience, send CBS News New York investigator Mahsa Saeidi an email at mahsa.saeidi@cbs.com.