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New Jersey health insurance

‘Garden State’ reduces uninsured rate but ACA is still contentious

  • By
  • contributor
  • August 20, 2014

New Jersey is predominantly a “blue” state, but the governor is a Republican and leadership hasn’t always seen eye-to-eye in terms of healthcare reform. Nevertheless, the state ranks relatively high in overall public health, and has expanded Medicaid under the ACA. A wide range of issues play a role in the health of a state’s residents.

Here’s a summary of health factors, outcomes, and healthcare reform in New Jersey:

New Jersey health ratings

The Commonwealth Fund’s 2014 Scorecard on State Health System Performance rated New Jersey 15th out of the 50 states and District of Columbia – up significantly from 23rd in 2009. New Jersey’s Scorecard includes details on how the ratings are calculated.

The state fared even better with America’s Health Rankings, which put New Jersey in 10th place in 2013. New Jersey’s rating is helped by a low incidence of drug deaths, and relatively few children living in poverty. The state also has an ample supply of primary care doctors and dentists. But New Jersey has public health challenges as well: Obesity and tobacco use both increased from 2012 to 2013, and the state has high rates of physical inactivity, preventable hospitalizations, and low birthweight.

Trust for America’s Health also compiled information on the prevalence of a multitude of illnesses and health indicators in New Jersey. The details are available in the 2014 listing of Key Health Data About New Jersey.

Within the state, health factors and outcomes vary from one county to another. You can see health data for New Jersey’s 21 counties with this interactive map created by the Robert Wood Johnson Foundation. In general, most of the northern half of the state ranks higher than most of the southern portion.

New Jersey and the Affordable Care Act

In 2010, New Jersey’s U.S. Senators – Democrats Frank Lautenberg and Robert Menendez – both voted yes on the ACA. In the U.S. House, eight Democrats voted yes, while five Republicans voted no. Lautenberg has since been replaced in the Senate by fellow Democrat Cory Booker, who is supportive of the ACA. The U.S. House now includes six Republicans and five Democrats from New Jersey, along with a currently vacant seat in the strongly Democratic 1st district.

New Jersey’s state legislature has a solid Democratic majority, although Republican Governor Chris Christie is not a fan of the ACA, calling it a “failed federal program” during a town hall meeting in March. But he did agree to expand Medicaid under the ACA, and has said he’s proud of that accomplishment, which allowed the New Jersey exchange to enroll nearly 180,000 people in Medicaid by mid-April. The state opted for a federally facilitated exchange, so HHS is running the exchange in New Jersey.

How did the ACA help New Jersey residents?

Have New Jersey residents gained access to affordable health insurance? In 2013, about 14.9 percent of New Jersey residents were uninsured. By mid-2014, six months after most of the ACA’s provisions were implemented, that number had fallen by over three percentage points, to 11.8 percent. The New Jersey exchange enrolled nearly 342,000 people during the first open enrollment period, including Medicaid/CHIP as well as private plans.

New Jersey enrollment in QHPs

Three carriers are participating in the New Jersey exchange: Horizon Blue Cross Blue Shield, AmeriHealth New Jersey, and Health Republic Insurance of New Jersey. Plans from all three carriers are available in all parts of the state.

Health Republic Insurance of New Jersey is the trade name for Freelancer’s CO-OP of New Jersey, a newly-created Consumer Oriented and Operated Plan (CO-OP) established under the ACA. CO-OPs in 22 states received a total of $2 billion in grants from the federal government to establish their programs. Freelancer’s CO-OP of New Jersey received $109 million.

161,775 people had enrolled in private plans through the exchange by mid-April when the 2014 open enrollment period ended, and 84 percent of them had received premium subsidies. A Kaiser Family Foundation study released in the fall of 2013 found that about 628,000 New Jersey residents would be potential customers for the exchange, and that about 400,000 of them would be eligible to receive premium subsidies.

So the state enrolled about a quarter of its eligible population in the first open enrollment period, leaving plenty of room for growth during the 2015 open enrollment that begins in November.

New Jersey Medicaid/CHIP enrollment

New Jersey’s acceptance of federal funding to expand Medicaid eligibility to 138 percent of poverty has played a significant role in reducing the state’s uninsured population (the ACA provided for Medicaid expansion in all states, but in 2012 the Supreme Court ruled that states could opt out, and 22 states have thus far avoided any type of Medicaid expansion).

In early 2014, a Kaiser Family Foundation report estimated that about 38 percent of the 1.3 million non-elderly uninsured residents in New Jersey would be eligible for Medicaid or CHIP under the expanded eligibility guidelines created by the ACA. As of mid-April, 179,872 people had enrolled in Medicaid through the New Jersey exchange. Enrollment in Medicaid is year-round, so that number has continued to increase, chipping away at the state’s uninsured rate.

State-based health reform legislation

Here’s a summary of recent New Jersey bills related to public health and healthcare reform: