N.Y. Co-Op Closure Could Place Consumers in Catholic Plan With Secondary Providers for Reproductive Health Services

November 19, 2015 — The closure of the New York health insurance co-op established under the Affordable Care Act (PL 111-148) could leave many New York residents automatically enrolled in a Catholic insurance plan that requires members to access certain reproductive health care services via secondary providers, Politico New York reports.


According to Politico New York, the state Department of Financial Services said New York officials are investigating the co-op, Health Republic, because it did not disclose accurate financial information. As a result, state and federal officials are closing down the co-op one month earlier than scheduled.

Health Republic members have until Nov. 30 to choose new coverage for 2016.

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Last week, Gov. Andrew Cuomo (D) said individuals enrolled in Health Republic would be automatically moved over to one of three insurers -- MVP, Excellus BlueCross BlueShield or Fidelis Care -- if they do not pick out a new plan by Nov. 30.

According to Politico New York, the majority of people who do not pick out a new plan likely will be enrolled automatically in Fidelis Care, also called New York State Catholic Health Plan, because that insurer is the largest of the three options and the only one that operates in New York City.

However, Politico New York notes that, unlike Health Republic, Fidelis does not cover abortion care, sterilization procedures or contraception. Instead, members have to access those services through secondary providers who have contracted with the state health department.

Andrea Miller, president of NARAL Pro-Choice New York, called the situation "a consumer-awareness problem." She added, "Most people don't realize if they are going to be automatically enrolled. If there is a delay, if women cannot access (contraception) in a timely manner, then the risk of unintended pregnancy increases dramatically" (Goldberg, New York Politico, 11/17).