Earlier today, New Jersey Policy Perspective (NJPP) joined health care experts and advocates to urge the State Senate to advance bill S3807 to establish a state health exchange. The proposal passed the Assembly earlier this week. Below is a statement from NJPP on the proposal, followed by Ray Castro’s full remarks (including new data on who would benefit from a state health exchange) given at today’s press conference.

RAY CASTRO, HEALTH POLICY DIRECTOR, NJPP: 

“Failure to establish a state health care exchange is nothing less than irresponsible, especially when there is such a great need for affordable health coverage. Without a state exchange, thousands of vulnerable New Jerseyans would be denied the affordable, quality health coverage they desperately need and the state would forfeit major federal funds that could further stimulate the economy. This should not be another political game in the statehouse, as health coverage can make the difference between life and death. All of the legislators in Trenton have guaranteed affordable health coverage; their constituents deserve the same.”

Full Remarks:

The Senate’s inaction to pass the bill which establishes a state exchange means that it would become impossible for the state to completely prevent President Trump sabotage of the exchange in New Jersey; thousands of vulnerable New Jerseyans would be denied the affordable, quality health coverage they desperately need; and the state would forfeit major federal funds that could further stimulate the economy. That would be tragic for the 330,000 uninsured New Jerseyans who are already eligible for Medicaid and the exchange subsidies but are not participating. For example, in New Jersey only about half of everyone who is eligible for federal premium subsidies are enrolled in the Marketplace compared to a 95 percent coverage rate in Massachusetts.

Why the difference?  One big reason is that Massachusetts has a state exchange; New Jersey does not.

So, who are the remaining uninsured in New Jersey? Mostly hardworking working families as well as some of the most vulnerable people in New Jersey who are trying to make ends meet in a state with one of the highest costs of living in the nation. Specifically:

• 81 percent live in a family with a full-time worker and another 10 percent are part time workers for a total of 91 percent who are working
• Nearly three quarters (72 percent) are people of color who historically have been discriminated against and who have much worse health outcomes than white residents
• 40 percent are very low income and earn less than $25,000 a year
• 78,000 are children, and
• 81,000 are older (55-64) who are not yet eligible for Medicare and are just trying to survive until they are.

Failure to enact legislation establishing a state exchange by the end of this month means that the state could lose hundreds of millions of dollars in federal funds annually to provide coverage for all the eligible uninsured in those two programs. For example, if the state covered all of the uninsured eligible New Jerseyans, it would generate $1.7 billion in federal funding annually.  Those funds would also create thousands of jobs and have a multiplier effect on the economy. Furthermore, the state would not be able to redirect the $50 million that the insurers are paying the federal government to operate the federal marketplace – money that should stay in New Jersey to create a stronger economy.

All of this additional assistance would also help hospitals reduce the growing debt many of them have seen as a result of people who are uninsured or who have insurance but the deductibles and other cost sharing are so high they cannot pay them.

There are four reasons why New Jerseyans are uninsured: 1) they are not aware that help is available; 2) they need assistance filling out the application for assistance; 3) the plans in the exchange   are still too costly for them; or 4) they are not eligible for any assistance such as their income may be just over the eligibility limit

A state exchange would mitigate or eliminate these barriers. For example, it would allow the state to double the length of the open enrollment period to 12 weeks from 6 week and it could use the redirected fees from the insurers to expand outreach and help the uninsured apply for assistance. A state exchange also allows the state flexibility to apply for and receive federal waivers, establish a Medicaid buy-in program for folks who are not otherwise eligible for subsidies, or provide state supplementary payments when federal subsidies are not enough to make insurance affordable.

Failure to pass this legislation when there such a great need for affordable health coverage is nothing less than irresponsible. This should not be another political game in the statehouse, health coverage can make the difference between life and death. The state has already done everything it can with a federal exchange, it time for it to take the next logical step and take over the exchange to guarantee that New Jerseyans are protected from astronomical medical charges.  All of the legislators in Trenton have guaranteed affordable health coverage; their constituents deserve the same.

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