New York's experience with building an insurance marketplace: A decade of success and lessons learned

This article reviews New York's experience with building an insurance marketplace after passage of the Affordable Care Act in 2010. Some of the article draws from the experiences of the authors, all of whom were, and some still are, involved with the New York State of Health (NYSOH). NYSOH has largely been a success if measured by total enrollment, affordability, and its ability to keep people enrolled during the recent unwinding. Factors that contributed to this success are important to document so that policymakers can note what elements of the administrative design and operation contributed to the increase in New Yorkers obtaining and staying insured.