Merging the Markets: Combining New York’s Individual and Small-Group Markets into Common Risk Pools

This NYHealth-funded United Hospital Fund Report models the effects of merging three segments of New York State’s commercial health insurance market: Direct Pay, Healthy New York, and Small Group.

This research hopes to contribute to the creation of a viable market in which individuals in New York State can purchase affordable, comprehensive health insurance policies.

Nearly 2 million New York State residents are covered through Direct Pay, Healthy New York, or Small Group. The report uses three scenarios to explore the impact on enrollee premiums, membership, and uninsurance if the three market segments were merged. It also investigates ways of mitigating potential premium increases. This body of research will contribute to finding a solution for the crisis in the individual market in New York State.