New Yorkers could soon get questionnaires from their health insurers asking for their race, ethnicity, gender, preferred language and sexual orientation as part of a state initiative that seeks to address disparities in health care.
State officials are proposing a new rule Tuesday that would require health insurance plans to collect demographic details as they sign people up for insurance or renew their coverage, although the information would be optional for New Yorkers.
The goal of collecting this data is to make it easier for insurers to identify the needs of the different communities they serve and address any gaps in access to care, according to Adrienne Harris, superintendent of the state Department of Financial Services, which regulates New York’s private health plans.
But Harris also acknowledged that such information could be misused and is including language in the draft regulations that aims to safeguard against insurance discrimination and various types of data sharing.
“When people do health equity policy, they really focus on the public plans, Medicare and Medicaid,” Harris said. “There isn’t as much focus on the commercial insurance market, which I thought was really a missed opportunity.”
Harris said the data could help insurance providers identify situations in which a particular group is not using all the health care services available to them and try to determine why that is. The data could help reveal if there are not enough health care providers with certain language skills or cultural competencies in a health plan’s network, Harris said.
Another scenario? “If we’re finding people aren’t accessing primary care because they don’t have good broadband and they can’t take advantage of telehealth,” Harris said. “There’s all sorts of things we could do.”
Health plans could also use the data to proactively beef up services to meet the needs of their members, said Elisabeth Benjamin, vice president of health initiatives at the Community Service Society of New York. She says her nonprofit has been advocating for the state to implement a measure like this for years.
“Say you have a large enrolled population of African American women of childbearing age in a section of Brooklyn, right? Then the carrier could do a better job of figuring out if they have adequate labor and delivery services available,” Benjamin suggested.
City and state officials are currently working to address persistent racial disparities in maternal health outcomes.
The demographic data would also be shared with the Department of Financial Services upon request.
Harris said after taking office in 2022, she surveyed commercial health plans to find out what they were already doing to address disparities in health outcomes among their members.
“What came back was mostly [information about] philanthropic efforts,” Harris said. “So, really good stuff, but not systematic, not robust, not consistent across the industry.”
Harris acknowledged the potential pitfalls of having insurers collect information about race and other demographic characteristics. Under New York law, health plans are prohibited from asking about race on insurance applications to prevent discrimination — although the new information would be collected in a survey that’s separate from the application for coverage.
The draft regulations emphasize that plans will still be subject to existing state laws that ban them from using protected characteristics such as race, national origin, gender, sexuality or marital status to set insurance rates or engage in other types of discrimination.
The proposal also includes provisions prohibiting insurers from selling the data that’s collected or using it for marketing purposes, even if the information is de-identified.
The state Health Plan Association, which represents insurers, did not immediately respond to a request for comment on the proposed rule.
The draft regulations will be subject to a 70-day public comment period, after which they could undergo revisions before being finalized.
