BY DENNIS BONE

Laws and regulations, especially those governing large corporations, can be difficult to understand. Often, that lack of understanding leads to a misrepresentation of the facts to stir up fear and prevent changes that would ultimately be for the greater good.

Unfortunately, this is now what I see taking place with S3218/A5119, legislation that would allow Horizon Blue Cross Blue Shield of New Jersey to adapt and better serve the changing needs of its members and New Jersey’s health care marketplace. What I see reminds me of that famous Carl Sandberg quote, “If the facts are against you, argue the law. If the law is against you, argue the facts. If the law and the facts are against you, pound the table and yell like hell.”

There’s an awful lot of table pounding and yelling coming from critics, but they offer no facts to support their fear-mongering and ignore the laws that debunk their wild theories and outlandish  claims.

Horizon BCBSNJ is a 90-year-old not-for-profit health service corporation, the only one in New Jersey. As a not-for-profit health insurer, it falls under the jurisdiction of both the Commissioner of the Department of Banking and Insurance (DOBI) and the Attorney General. Both have enormous power to enforce the rules that are in place to protect Horizon’s members and the value of its nonprofit assets that must be preserved.

S3218/A5119 changes not one single thing about that. Critics seem to suggest that Governor Murphy, Attorney General Grewal, DOBI Commissioner Caride, and legislative leaders who have substantial oversight over Horizon will not do their job and as a result are part of some massive conspiracy designed to defraud the public of its rightful interest in the value amassed inside the not-for-profit Horizon BCBSNJ. If you don’t have the facts, yell like hell.

The law and the facts are clear:

• A reorganized Horizon would be required to maintain the very same mission it has had from the start and it would only be able to invest in businesses that are connected to health care. The current law limits how much they can invest today and that is preventing them from doing what Blue Cross Blue Shield plans in 18 other states can do: create new partnerships and businesses that make health care more convenient, more connected and more affordable for its members. If it isn’t related to health or health care, Horizon will not be allowed to do it. And the Attorney General has the power to make sure that occurs.

• The DOBI Commissioner retains the authority it has today to determine whether and how much of Horizon’s reserves can be re-deployed to creating new partnerships and businesses that improve the health care products and services it can offer to its members. Under this bill, the Commissioner must approve the re-deployment of reserves to make sure that Horizon remains financially strong to meet its primary health insurance obligations.

• The legislation includes an outright, specific, and unambiguous prohibition on the re-organized Horizon – which retains its not-for-profit, charitable and benevolent obligations – from becoming a for-profit stock company. No for-profit conversion, period.

• Horizon would remain a not-for-profit, charitable and benevolent company. Those terms have specific legal meaning and the Attorney General of New Jersey has immense power to enforce them. FACT: a not-for-profit entity cannot legally transfer any portion of its value to a private, for-profit interest. New Jersey law prohibits private inurement and the Attorney General has the power and duty to enforce that law. The public’s interest in the value of Horizon is protected by a set of laws that are not being modified in any way by this legislation.

S3218/A5119 provides no road to conversion for Horizon. It creates no stockholders. In essence, it does none of the things that opponents are accusing it of doing. What it does do is allow Horizon to invest more to create the kinds of health care opportunities we sorely need right now. It means the same Horizon, but better! We hope the Legislature will pass this bill so that the Governor can sign it into law.

Dennis Bone is President of Move Health Care Forward New Jersey, a 501(c)(4) dedicated to educating the public on the value of modernizing New Jersey’s health care laws. Bone was the president and CEO of Verizon New Jersey from 2000 to 2012 and recently served as the founding director of the Feliciano Center for Entrepreneurship at Montclair State University.