New York Codes, Rules and Regulations
Title 9 - EXECUTIVE DEPARTMENT
Subtitle A - Governor's Office
Chapter I - Executive Orders
Part 8 - Executive Orders (Andrew M. Cuomo)
Section 8.42 - Executive Order No. 42: Establishing the New York Health Benefit Exchange

(1) result in lower premiums for individuals and small businesses;

(2) allow individuals and small businesses purchasing coverage through such Exchange to receive $2.6 billion in federal tax credits and cost sharing subsidies; and

(3) provide one million additional New Yorkers access to affordable, comprehensive health insurance, reducing the percentage of New Yorkers who are without health insurance;

WHEREAS, a state that chooses to operate its own Exchange must demonstrate to the federal government, by January 1, 2013, that its Exchange will be able to begin accepting applications by October 1, 2013, and will be operational by January 1, 2014, and if the state does not demonstrate operational readiness of its own Exchange, its residents will be required to participate in a federal Exchange;

(1) understand the ramifications of operating an Exchange within New York's commercial insurance market;

(2) consider the unique regional and economic needs of the State's individual and small business health insurance markets;

(3) account for the diversity of its population, with its ethnic, cultural and language differences; and

(4) decide what benefits will be provided to enrollees in the Exchange, which health plans can participate in the Exchange, what rules should apply to the marketing of products by health plans, and how to operate the Small Business Health Option Program ("SHOP") for small businesses;

WHEREAS, the Affordable Care Act requires an Exchange to evaluate the eligibility of individuals for Medicaid and other public health coverage and enroll them if eligible, meaning that it will be essential to coordinate the operations of the Exchange with the State's administration of these programs;

WHEREAS, the taxpayers of this State subsidize the costs associated with care for the 2.7 million New Yorkers without health insurance, who frequently forego preventive care and other needed treatment, putting them at risk of being sicker throughout their lives and dying sooner than those who have health insurance, which diverts funds from other public uses and costs state and county taxpayers more than $600 million annually just to pay for a portion of the services rendered by hospitals to people without insurance;

WHEREAS, New York's uninsured working families often earn too much to qualify for public health insurance, but not enough to purchase coverage that costs, on average, over $1,200 per month for an individual and $3,450 per month for a family of four;

WHEREAS, small businesses, without assistance, cannot afford to purchase health insurance coverage for their workers, nearly 800,000 of whom have lost employer-sponsored coverage over the last decade, and thus face a major competitive disadvantage that inhibits their ability to grow, create jobs and otherwise support the State's economic development;

WHEREAS, the costs associated with care for the uninsured are shifted through increased premiums to those individuals and groups that purchase health insurance coverage, causing working families with health insurance to pay $800 more in premiums on average each year;

WHEREAS, the development and operation of an Exchange in New York will impose no cost on the State, but will be funded entirely with federal funds until January 1, 2015, at which time the Exchange will be wholly self-funded, meaning that no State or county taxpayer dollars will be used for such purposes; and

WHEREAS, it is therefore critical that the State of New York establish and operate its own Exchange, and that it do so expeditiously;

NOW, THEREFORE, I, Andrew M. Cuomo, Governor of the State of New York, by virtue of the authority vested in me by the Constitution and the Laws of the State of New York, do hereby order as follows: