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 have joined 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.
What about premiums?
In the Newark area, the second-lowest-cost silver plan (the benchmark plan) could be less expensive in 2015 than it was in 2014. According to data from the Kaiser Family Foundation, the average in 2014 for a 40 year old non-smoker was $322 per month, and that’s dropped to $316 per month for 2015 (though in most areas, staying with the benchmark plan means switching carriers for 2015).
The New York Times Upshot has an interactive map that highlight the importance of shopping around during the 2015 open enrollment period. For New Jersey residents (Newark area) who had the benchmark plan in 2014 and opt to simply renew that same plan, the average rate increase for 2015 is roughly 11 percent. But people who shop around and switch to the new benchmark plan will see an average rate increase of just 2.2 percent.
The relatively low level of competition in 2014 – just three carriers in the exchange – is one of the reasons given for the higher-than-average premiums in New Jersey during the first open enrollment period. 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 was $332 in 2014, compared to a national average of $249 a month. But the entry of two new carriers has helped to hold down the average benchmark plan rates for 2015.
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.
Targeted outreach and more experienced navigators
Navigator organizations in New Jersey have more data and experience in the second open enrollment period than they did a year ago. They have zip code based information in terms of where people have enrolled and where there are still large pockets of eligible people, so they can better target their outreach.
Get Enrolled America’s New Jersey branch learned last year that recurring enrollment events work better than one-time events, and also that people are more likely to enroll after being contacted at least four times. They’re incorporating that information in their enrollment strategies for 2015.
The New Jersey for Healthcare Coalition has an improved website – CoverNJ.org – where people can find local assistance with the enrollment process and learn more about the ACA and enrollment in general.
How many people have enrolled?
The 2015 open enrollment period began on November 15, and will continue through February 15. People who want their new coverage to be effective January 1 need to enroll by December 15. New Jersey has a federally-run exchange, and HHS has not yet released a state-by-state enrollment report for 2015.
But they did provide a snapshot look at enrollments during the first week: From November 15 to 21, a total of 462,125 people had enrolled in coverage in the 37 states where HHS is running the exchange (ACA Signups predicts that number had grown to 780,000 by November 29). We don’t yet know how many of those enrollees are in New Jersey, but during the 2014 open enrollment period, NJ had nearly three percent of the total enrollment through HealthCare.gov.
Joel Cantor, director of the Rutgers Center for State Health Policy, estimates that total private plan enrollment in the New Jersey exchange could reach 250,000 people by the end of the 2015 open enrollment period.
For the 2014 open enrollment period, by April 19, 161,775 people had completed their enrollment in private plans through the New Jersey exchange. 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.
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.
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.
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, and has continued to grow. From December 2013 through October 2014, total Medicaid enrollment in New Jersey grew from 1.28 million to 1.65 million people.
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