New Jersey Medicaid

Medicaid enrollment has grown by nearly 500,000; Uninsured rate down 35%

Where in your state to call or visit for Medicaid.How to apply

Online at HealthCare.gov, or through the NJ Family Care online application.  You can apply by phone at 1-800-318-2596 or contact NJ Family Care for assistance at 1-800-701-0710.

Who is eligible in your state to get Medicaid?Who is eligible

The aged, blind, and disabled.  Also, adults with income up to 138% of poverty, and pregnant women with income up to 200% of poverty.  Children are eligible for Medicaid or CHIP with income up to 350% of poverty.

  • By
  • healthinsurance.org contributor
  • September 27, 2016

New Jersey expanded Medicaid in accordance with the ACA, utilizing federal funding to provide health insurance for the newly-eligible population starting in 2014.

As a result, New Jersey’s total Medicaid enrollment increased by nearly 36 percent (465,549 people) between the fall of 2013 and July 2016. Total Medicaid enrollment in New Jersey as of July 2016 stood at 1.75 million people. Through the end of 2015, New Jersey’s uninsured rate dropped by 35 percent, compared with where it was at the end of 2013.

Who is eligible?

In addition to the aged, blind, and disabled, the following New Jersey residents are eligible for Medicaid:

  • Adults with incomes up to 138 percent of poverty
  • Children with household incomes up to 350 percent of poverty are eligible for CHIP in New Jersey.  This is one of the most generous thresholds in the country.
  • Pregnant women with incomes up to 200 percent of poverty (unchanged from 2013).

How do I apply?

In New Jersey, all Medicaid coverage – including previously eligible populations as well as the population that is newly eligible under the Medicaid expansion guidelines – is handled by NJ Family Care.

Medicaid enrollment is available year-round. Applicants can apply for Medicaid via HealthCare.gov, or through the NJ Family Care online application.

The NJ Family Care website also has paper applications that can be downloaded, although they strongly encourage online applications. They can be reached by phone at 1-800-701-0710 if applicants need assistance.

The decision to expand Medicaid

New Jersey was one of five states that opted to partially expand Medicaid well ahead of the 2014 state-date that most states used. In New Jersey, adults with incomes up to 23 percent of poverty were able to start enrolling in Medicaid in April 2011. This is still a very low income (as of 2016, 23 percent of poverty level is just $2,732 in annual income for a single person), but it’s better than nothing – more than half of the states provided no health coverage assistance at all to low income adults without children prior to 2014, and there are 18 states that still provide no assistance to childless adults living in poverty.

In February 2013, Governor Chris Christie agreed to accept federal funding for full Medicaid expansion, and later that year he signed a budget that included $227 million in federal Medicaid expansion funds.

But Christie’s acceptance of Medicaid expansion hinged on a provision that the state would only continue to offer expanded Medicaid as long as the federal government maintains its promise to always pay at least 90 percent of the cost of covering the population eligible under the expansion guidelines.

In June 2013, Christie vetoed a state bill that would have made Medicaid expansion permanent regardless of any future changes in the federal funding rate, and NJ’s Medicaid expansion is still contingent on continued federal funding.  Many other states have adopted similar provisions in their Medicaid expansion agreements.

In early 2014, Governor Christie said that he was “proud” of the state’s decision to expand Medicaid, but emphasized that more needed to be done to control costs in the $12 billion NJ Medicaid program.

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