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New Jersey health insurance exchange

new-jersey guide to health insurance

New Jersey health insurance exchange

By
healthinsurance.org contributor
July 24, 2014

Thanks to qualifying events and special open enrollment periods, enrollment in the New Jersey exchange has continued to grow in the two months since 2014 open enrollment ended.  But there won’t be another official HHS report on the total enrollment numbers until November.  161,775 people had completed their enrollment in private plans through the New Jersey exchange by April 19, well in excess of double the number who had done so as of the first of March.  Private plan Obamacare enrollments in the New Jersey exchange were nearly 70 percent higher than HHS had predicted last year, prior to open enrollment (the projection was about 113,000 people in 2014).  Every state saw a surge in enrollment in March and early April, but New Jersey’s was the seventh largest  surge in the country.  An additional 179,872 people had been found to be eligible for New Jersey’s expanded Medicaid through the exchange by mid-April.

In late February, 11 New Jersey lawmakers – all Democrats – partnered with Get Covered America to volunteer their time in helping NJ residents get enrolled in the exchange.  The lawmakers’ staff members also helped with the enrollment effort, which was Get Covered America’s largest partnership with state lawmakers in the country.  Their involvement was part of the reason for the extremely successful final couple of months of open enrollment in New Jersey.

The New Jersey Assembly passed two bills authorizing a state-run exchange in 2012, but both were vetoed  by Gov. Chris Christie. Those vetoes left the federal government to operate the health insurance marketplace in New Jersey.  Governor Christie has taken a very hands-off approach to the ACA, and the state has done little to promote the HHS-run exchange, leaving most of the heavy lifting to brokers, navigators and HHS.  In mid-January, U.S. Rep Bill Pascrell (D, NJ) introduced a bill that would allow HHS to recoup ACA outreach funding that remains unused by Republican governors like Christie who have refused to use the money in their states to promote the ACA and educate residents about its benefits.

New Jersey officials were involved in lengthy discussions with HHS over the use of $7.67 million in federal funds that had been granted to NJ in 2012 to use for promoting the state’s health insurance exchange.  The money was intended for outreach, advertising and general promotion of the ACA and the exchange, although NJ officials wanted to use it to staff a call center for the state’s expanded Medicaid program.  But HHS had made it clear last year that such a use was not permitted.  Ultimately, the state and HHS were not able to come to a compromise on the issue.  New Jersey forfeited the money on February 20 when the deadline passed, and HHS officially rescinded the funds in early May.

In 2014, three health insurers are offering 29 options for individuals and families in New Jersey: Horizon Blue Cross Blue Shield, AmeriHealth New Jersey and Health Republic Insurance of New Jersey. Health Republic is a new consumer oriented and operated plan, or co-op, created under a provision of the ACA. Aetna initially intended to participate, but dropped out in September.  A fourth carrier – United Healthcare – will be joining the New Jersey exchange this fall, offering policies for 2015.

The relatively low level of competition is one of the reasons given for the higher-than-average premiums in New Jersey. According to a report released by the U.S. Department of Health and Human Services (HHS), the average cost for a bronze plan —the lowest-cost option — in New Jersey is $332, compared to a national average of $249 a month.  An HHS survey in mid-June found that New Jersey had the highest average after-subsidy cost for health insurance among the 36 states where HHS is running the exchange: $148 in New Jersey, compared with an average of $82 across all 36 states.  This is indicative of not only higher unsubsidized premiums, but also higher average incomes in NJ, and perhaps an affinity for plans with higher metal levels.  For people with the same income level (assuming they are subsidy-eligible), it doesn’t matter what state they live in or how expensive the unsubsidized premiums are – the subsidy amounts will differ, but the after subsidy premiums for silver plans will be the same, since the ACA sets net premiums as a percentage of income.

According to U.S. Department of Health and Human Services (HHS), about 901,000 New Jersey residents are uninsured and eligible to use the health insurance marketplace to purchase insurance. HHS also estimates that about 790,000 people in New Jersey will be eligible for subsidies to purchase insurance or will qualify for coverage through the state’s expansion of Medicaid, which was authorized by the New Jersey Assembly and signed into law by Christie.

New Jersey health insurance exchange links

HealthCare.gov
800-318-2596

State Exchange Profile: New Jersey
The Henry J. Kaiser Family Foundation overview of New Jersey’s progress toward creating a state health insurance exchange.

New Jersey Health Insurance Exchange
An overview of health exchange issues from the consumer advocacy group New Jersey Citizen Action.

Principles for Establishing a Pro-Consumer NJ Health Insurance Exchange (PDF)
From NJ For Health Care