New York Governor Andrew Cuomo issued an executive order April 12 establishing a statewide competitive health insurance exchange to mixed reviews. The Governor issued Executive Order No. 42 after the Senate failed to pass similar legislation.

Under the the federal Affordable Care Act, states must enact statewide exchanges or participate in a federal one. State exchanges must begin taking applications by October 1, 2013; be operational by January 2014; and be financially self-sustaining, requiring no state subsidies, by January 2015. The New York exchange complies with those requirements, and will be established using federal funds.

According to the executive order, nearly 800,000 workers in New York have lost employer-sponsored coverage over the last decade. The exchange will allow individuals and small businesses to receive $2.6 billion in federal tax credits and cost sharing subsidies, and is expected to cut healthcare costs for small businesses by 22 percent.

Reaction. “Any rush towards enacting Obamacare is more political than reality,” said Senator Greg Ball. “The promise of federal funding is not without strings and the program itself will ultimately, if enacted, cost New York taxpayers billions of additional dollars that we do not have. Furthermore … there is zero need to build an initial framework for a large and expensive government program that may never get off of the ground.”

Heather Briccetti, President and CEO of The Business Council of New York State, Inc., said, “The cost of health care remains the number one cost concern for businesses across New York. [The exchange] will allow New York to have greater control over how federal healthcare reform will affect its citizens.”