TriState | Fall | 2009 | Health Plan Analysis

The individual health insurance markets in New York and New Jersey are a study in contrasts, despite the fact both are highly regulated to guarantee residents a certain level of coverage. New Jersey's individual market is taking off-a reflection of both the economic downturn and the state's loosening of pricing restrictions on the highly regulated individual market. New York's individual market, however, is shrinking and getting pricier by the day. That's why an advocacy group opposed a new state law allowing the Freelancer's Union to establish its own insurance agency to cater to a specific segment of the workforce. New Yorkers for Accessible Health Coverage believes luring independent workers away from the individual market will further distill it into an unviable high-risk pool. In Connecticut, health plans and providers have come together in a historic data-sharing project in which an estimated 4,000 physicians throughout Connecticut can now track their progress in meeting national guidelines for tests and screenings for chronic conditions such as diabetes and coronary artery disease. Meanwhile, the aggressive measures by Horizon Blue Cross Blue Shield of New Jersey to get its out-of-network medical costs under control have sent tension levels to a new high in its relations with the provider community.