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Is Private Health Insurance Cheaper Than ACA in New York?
Short answer: for a healthy person who doesn't qualify for a subsidy, yes, usually by a wide margin. For everyone else, usually no. Here's the math behind that.
When private wins in New York
Take a healthy 42-year-old in New York City earning $95,000. On NY State of Health with no subsidy, a Silver plan from Fidelis Care, Healthfirst, Anthem (Empire), EmblemHealth, MVP, and Oscar is roughly $650–$800 a month in 2026. A private PPO on the MagnaCare PPO network for the same person is roughly $380–$480. That's $3,000–$4,500 a year, with a broader network.
When ACA wins in New York
Same person earning $45,000: the premium tax credit could bring that Silver plan under $200 a month. No private plan competes with that. Same person with Type 1 diabetes or a recent cancer diagnosis: private plans may decline or exclude; the marketplace accepts them at the same price as anyone else. Medicaid is expanded, plus the Essential Plan up to 250% of the poverty level in New York.
What "cheaper" has to include
Compare out-of-pocket maximums, not just premiums. Many private PPOs have individual out-of-pocket caps around $6,000–$9,000, similar to marketplace Silver plans. Check that your doctors are in the PPO network. And remember private plans are month to month — if your income drops into subsidy range during the year, you can move to the marketplace at the next open enrollment or life event.
The New York factor
New York uses pure community rating — a 25-year-old and a 64-year-old pay the same marketplace premium — and the state restricts most non-ACA plans. Private options in New York are narrower than in other states, so the honest answer here is usually a careful comparison, not a promise of savings.
We run both quotes for every client — it's the only honest way to answer the question. Start here.