(Remapping Debate) New York’s health insurance exchange (called “NY State of Health”) offers individuals and families numerous insurance plan options at various “metal” levels. What it doesn’t offer in most parts of the state are plans that provide coverage for non-emergency out-of-network care. In a sample Manhattan zip code, for example, there are 62 plans available at all metal levels. Not one of those plans pays for out-of-network care (see graphic).
This outcome is not a “glitch,” a State Department of Health official has confirmed to Remapping Debate. Instead, it is a function of New York’s decision to permit insurers to elect whether or not to sponsor plans that include out-of-network coverage. That decision, some worry, will have a negative impact on patient choice and patient care.