Two new carriers brings exchange total to five
In 2014, only three carriers participated in the exchange in New Jersey: Horizon Blue Cross Blue Shield, AmeriHealth, and Health Republic of New Jersey. For 2015, two more carriers are joining them: UnitedHealthcare and Oscar Health Insurance.
Health Republic is a new consumer oriented and operated plan, or co-op, created under a provision of the ACA, and Oscar Health Insurance is an innovative new carrier that started in New York last year and is expanding to New Jersey.
More health plans on the horizon?
In mid-October, two NJ hospital systems – Hackensack University Health Network and Meridian Health – signed preliminary paperwork to begin a merger process, although the deal still has to be approved by regulators. If approved, Hackensack Meridian Health would become the largest hospital system in NJ, and would include nine acute-care hospitals, two children’s hospitals, and numerous doctor’s offices, rehab centers, skilled nursing facilities, and assisted living centers.
Officials are predicting that if it goes forward, the merger will lead to the creation of new provider-managed health insurance plans, which could bring more competition to the NJ health insurance market.
How many people have enrolled?
By April 19, 161,775 people had completed their enrollment in private plans through the New Jersey exchange, 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.
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 HHS will not release an official enrollment total again until November.
The carriers in New Jersey have been forthcoming with their enrollment numbers though. AmeriHealth had 130,000 enrollees as of early September (up from about 10,000 at the end of 2013), and Horizon BCBS had 140,000 by mid-August. Health Republic had enrolled roughly 4,000 new members. These totals are for the carriers’ full book of business, including both on and off-exchange enrollments. But AmeriHealth reported that the majority of their new enrollments have been through the exchange.
What about premiums?
Rates for 2015 have not been released yet in New Jersey, but the entry of two new carriers into the exchange should go a long way in holding down rate hikes. The relatively low level of competition – just three carriers in 2014 – is one of the reasons given for the higher-than-average premiums in New Jersey this year. According to a report released by the U.S. Department of Health and Human Services (HHS), the average 2014 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.
ACA’s impact on the uninsured rate
In addition to the people who have purchased private plans through the exchange, another 201,095 people had enrolled in New Jersey’s expanded Medicaid by early June. Medicaid enrollment is year-round; this was an increase of 46,674 people since the April report from HHS.
In September 2013, New Jersey’s uninsured rate was 21.2 percent. By June 2014, that rate had dropped to 11.5 percent, according to a study by the Robert Wood Johnson Foundation. In less than a year, the ACA has halved the uninsured rate in New Jersey.
Congressional outreach and legislation
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.
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 Chris 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.
History of the New Jersey exchange
The New Jersey Assembly passed two bills authorizing a state-run exchange in 2012, but both were vetoed by Gov. 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.
The state did opt to expand Medicaid however, making health insurance available to hundreds of thousands of low-income residents.
New Jersey health insurance exchange links
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