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Rep. Chris Collins, R-Clarence, speaks during a CNN town hall on March 16, 2017. Rep. Chris Collins, R-Clarence, speaks during a CNN town hall on March 16, 2017.

Rep. Chris Collins, R-Clarence, speaks during a CNN town hall on March 16, 2017.

By Dan Clark March 31, 2017

New York state prohibits higher health insurance premiums for older residents

Democrats in Congress say the Obamacare repeal and replacement bill would have allowed health insurance companies to charge older Americans more for coverage.

The American Health Care Act -- pulled from the House floor last week after it became clear the plan would be defeated -- would have allowed insurance companies to charge older Americans up to five times more for health coverage than younger Americans.

Rep. Chris Collins, R-Clarence, addressed the issue during a town hall-style event on CNN before Republican leaders pulled the bill.

"In New York under our state insurance commissioner, we have what we call a one to one," Collins said. "You cannot charge an older person even one dollar more than a younger person."

The Affordable Care Act remains the law. While insurance companies are still allowed to charge older Americans up to three times more for coverage under that law, Collins says that’s not the case in New York state.

Is he right that New York state residents pay the same price for insurance regardless of age?

New York state law

New York state has had what’s called a "community rating" model of health insurance since 1993. It requires health insurance companies to charge the same price for coverage in select regions regardless of age, gender, occupation or health status.

The bill, sponsored in 1992 by Assemblyman Pete Grannis, a Democrat from New York City, passed with bipartisan support from both chambers and then-Gov. Mario M. Cuomo.

The bill changed the state’s insurance law from the federal model, which allows different pricing based on age, and guaranteed "the premium for all persons covered by a policy or contract form is the same … without regard to age, sex, health status or occupation."

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It remains on the books today and now includes the same protection for tobacco users.

Although the price is the same for different ages within each region, the regions are allowed to have different prices statewide. There are eight regions in the state.

Vermont is the only other state that requires the same health insurance price for all ages.

What about federal law?

Experts we spoke to said New York state’s model works with the Affordable Care Act and would not have changed under the American Health Care Act.

"Federal law preempts state law, but sometimes it creates a floor instead of a ceiling for actions that can be taken by the states," said Rachel Morgan of the National Conference of State Legislatures. "You must also consider that states until recently were the principal regulators of the business of insurance and instituted requirements that best served their markets."

The floor, in this case, is the federal cap on age-based health care premiums. New York state’s law stands because its added restriction does not change federal law but supplements it.

Our ruling

Collins said in New York "you cannot charge an older person even one dollar more than a younger person" for health insurance.

Collins is right. New York state has barred insurance companies from pricing based on age for more than two decades. Experts say the Affordable Care Act did not impact that law, and its would-be Republican replacement would not have either.

We rate his claim True.

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In New York state, "you cannot charge an older person even one dollar more than a younger person" for health insurance.
New York
Thursday, March 16, 2017

Our Sources

Rep. Chris Collins appears on "The Messy Truth", CNN, March 16, 2017

Assembly Bill 12350-A, 1992, sponsored by Assemblyman Pete Grannis

Assembly and Senate journals from the 1992 legislative session

Chapter 501 of 1992, signed by Gov. Mario Cuomo

Section 3231 of the State Insurance Law

Email and phone conversation with the Department of Financial Services

New York’s eight regions for the community rating health insurance model

Email conversation with Prof. Sabrina Corlette from the Health Policy Institute at Georgetown University

Implementing the Affordable Care Act: State Approaches to Premium Rate Reforms in the Individual Health Insurance Market, The Commonwealth Fund, Dec. 2014

Email conversation with Rachel Morgan, health and human services expert from the National Conference of State Legislatures

The American Health Care Act (Republican replacement for Affordable Care Act)

"AARP Opposes Health Care Bill", March 7, 2017

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More by Dan Clark

New York state prohibits higher health insurance premiums for older residents

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