Authorizes the Marketplace to award grants to entities to serve as navigators that can help individuals apply for health insurance.
Summary
This bill amends the Public Health Law to expand the New York State of Health Marketplace’s authority to fund navigator and enrollment-assistance programs. Under existing law, the Marketplace may already award grants to entities that serve as navigators, provide community-based enrollment assistance, or certify licensed insurance producers to help eligible individuals and small employers. The bill keeps those programs in place and adds a new requirement that, subject to appropriation, the Marketplace award additional grants each year to providers in New York City and in counties where the share of uninsured residents below 400% of the federal poverty level is above the statewide average.
The practical effect is to direct more outreach and enrollment resources toward areas with higher uninsured rates, especially low- and moderate-income populations. By targeting grants geographically, the bill seeks to improve access to health insurance enrollment help in communities that may have greater need for assistance navigating the Marketplace and available coverage options. The bill takes effect on the first day of January following enactment.
Impact
The bill would amend subdivision 15 of section 268-c of the Public Health Law, which governs Marketplace navigator and enrollment-assistance grant programs. It does not create a new insurance benefit or change eligibility rules for coverage, but it does require the Marketplace to prioritize additional grant funding, if appropriated, for providers in New York City and counties with uninsured rates above the statewide average for people below 400% of the federal poverty level. The affected parties are Marketplace grant recipients, navigators, community-based enrollment assisters, licensed producers, and residents in higher-uninsured areas who may receive expanded assistance.
Sentiment
The available context suggests generally supportive sentiment toward the bill’s purpose, as it is framed as helping individuals apply for health insurance and expanding access to enrollment assistance. No committee transcript or recorded vote is available, so there is no evidence of formal opposition in the provided materials. The bill’s focus on underserved areas and uninsured populations indicates a policy goal that is likely to be viewed favorably by health access advocates.
Contention
The main potential point of contention is the bill’s targeted funding approach. By directing additional grants to New York City and counties with uninsured rates above the statewide average, the bill may raise questions about how those counties are identified, whether the formula is equitable, and whether other regions with significant need could be left out. Another possible issue is that the added grants are expressly subject to appropriation, meaning the program’s expansion depends on future funding decisions rather than an automatic mandate.
Relates to certain procedural protections granted to third-party sellers and seller profiles of online marketplaces; provides that online marketplaces must provide notice and an opportunity to respond before a seller or profile is suspended; provides that a suspended third-party seller or seller profile shall have the right to appeal the determination of the online marketplace in seeking account reinstatement.
Requires all online marketplaces to require every person engaged in a transaction on its marketplace website, application or software, to verify their identity with the online marketplace.
Relates to certain procedural protections granted to third-party sellers and seller profiles of online marketplaces; provides that online marketplaces must provide notice and an opportunity to respond before a seller or profile is suspended; provides that a suspended third-party seller or seller profile shall have the right to appeal the determination of the online marketplace in seeking account reinstatement.
Directs the department of financial services to study health insurance coverage through the Marketplace, including collecting data on how many people are insured, and studying the feasibility of creating programs, subsidies, and/or tax credits to help expand health care coverage.
Relates to authorizing grants for the implementation of the seal of civic readiness program; authorizes grants of $50,000 to no more than 20 applicant school districts for public schools that have successfully completed both the seal of civic readiness application and commissioner created grant application.
Requires an insurance company which owns a health care provider to pay any health care provider which it does not own an amount that is no less than the amount that it pays a health care provider which it does own for a comparable service; prohibits an insurance company which is owned by a health care provider from paying any health care provider which does not own such insurance company an amount that is less than the amount that it pays a health care provider which does own such company for a comparable service.
Requires an insurance company which owns a health care provider to pay any health care provider which it does not own an amount that is no less than the amount that it pays a health care provider which it does own for a comparable service; prohibits an insurance company which is owned by a health care provider from paying any health care provider which does not own such insurance company an amount that is less than the amount that it pays a health care provider which does own such company for a comparable service.