Expanding Health Care Coverage

Project Title

Implementing Health Reform: Addressing Issues of Benefits, Provider Networks, and Market Structures

Grant Amount


Priority Area

Expanding Health Care Coverage

Date Awarded

November 21, 2011







The Affordable Care Act (ACA) stipulates new standards on existing insurance markets, and offers New York State discretion and latitude in formulating its own programmatic rules and policies.

The United Hospital Fund (UHF) continued to navigate and analyze the new law’s criteria, with a focus on New York’s public and private insurance markets, along with the essential health benefits and array of provider networks available to New Yorkers. UHF produced new, actionable information to guide the most immediate State decisions about health reform, both how to operationalize it and how to leverage it for wider gains.

UHF provided insight on coverage in state exchanges under the provision of federally mandated “essential benefits package,” including the differences between New York State mandated benefits and new Federal benefit standards; assessed how New York currently undertakes its network reviews and defines network adequacy; and completed a review of New York’s commercial, Medicare, Medicaid, and self-funded insurance markets. UHF informed and advanced the implementation of Federal reform coverage expansions, and analayzed the choices made by the State as it adapts to new Federal rules. UHF engaged influential leadership from across the State’s public and private sectors to advance decision making, and updated its encyclopedic analysis, The Big Picture, with the implementation decisions New York faces in creating an exchange and regulating health insurance markets.

Read the following grant reports associated with this grant: