New York's Affordable Care Act marketplace, NY State of Health, capped its seventh annual open enrollment period with an announcement that nearly five million state residents had signed up for coverage in 2020, including about 273,000 purchasers of qualified health plans in its individual market component, both high-water marks. Enrollment occurring during the special coronavirus open enrollment period will add to those totals. New York's other source for individual coverage--the off-exchange market--has contributed to the overall improvement of the individual market in New York, but membership has been declining of late. At the same time, a Trump administration immigration regulation that took effect on February 24, 2020, could lead noncitizens to drop public coverage or seek commercial coverage. This issue brief examines the off-exchange market and presents some options for a timely tune-up, with a focus on barriers that prevent noncitizens from enrolling off-exchange, a grave concern during the current coronavirus pandemic.
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