Implementing New York's Family Health Plus Program: Lessons from Other States

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Implementation of New York State's new health insurance program, Family Health Plus, began in October 2001. Family Health Plus makes comprehensive health insurance available to low-income working adults who earn too much to qualify for Medicaid but lack access to group insurance coverage. Adults without dependent children qualify if their gross income is less than 100 percent of the federal poverty level, regardless of financial assets. For parents with dependent children, the threshold is 150 percent of poverty.

If it is successful at enrolling and retaining eligible residents, Family Health Plus could make New York a national leader in providing adults with health coverage. But in the Commonwealth Fund-sponsored study Implementing New York's Family Health Plus Program: Lessons from Other States, Rima Cohen and Taida Wolfe warn that the program could fail to reach many eligible residents if the state does not simplify enrollment and promote greater coordination with other health insurance programs, especially Medicaid and Child Health Plus.

The authors note that other states which have extended health coverage to adults in recent years can provide New York with important lessons. Based on other states' experiences and reforms, they recommend the following strategies for New York:

Outreach and Marketing
  • Launch aggressive advertising and outreach campaigns for all health insurance programs, including specific strategies for reaching nontraditional coverage populations, such as childless adults.
  • Review all public programs with eligibility guidelines similar to those of health insurance programs to identify residents who may be uninsured and eligible for subsidized coverage.
  • Supplement state-sponsored outreach efforts with corporate-sponsored activities.


Program Simplification
  • Establish a single, streamlined application for all public health insurance programs. Eliminate questions not required by federal law. Minimize number of documents required to verify applicants' information.
  • Allow people to mail in their applications.
  • Outstation Medicaid eligibility workers in hospitals and health centers serving the poor.


Program Coordination
  • Integrate information systems for all health insurance programs.
  • Make rules and procedures for health insurance programs as uniform as possible.
  • Require health plans that participate in one program to accept enrollees from all programs.
  • Automate enrollment to make applications available online and allow applicants to be easily screened for more than one program.


Recertification
  • Shorten and simplify recertification forms and require applicants to provide only those documents necessary to demonstrate changes in circumstances that cannot be verified in existing government records.
  • Align recertification dates for all family members; allow mail-in of renewal forms.
  • Educate enrollees about the recertification process when they first enter the program.
  • Dedicate program staff to target individuals in danger of disenrolling.

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Publication Details

Publication Date:
November 1, 2001
Authors:
Rima Cohen and Taida Wolfe
Citation:

Implementing New York's Family Health Plus Program: Lessons from Other States, Rima Cohen and Taida Wolfe, The Commonwealth Fund, November 2001


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