Our governor’s response to the U. S. Affordable Care Act (ACA) has created a quagmire. He did decide to support the Medicaid Expansion provision to be funded for several years entirely by the federal government. However, he refused to adopt a New Jersey operated Health Exchange. Such will result in us having a federally operated program less attuned to the needs of our state and less consumer friendly.
More importantly in rejecting a NJ operated Health Exchange he surrendered millions of dollars that could be used for outreach to enroll patients. As NJ Policy Perspective (NJPP) points out, “Maryland, which will operate a state based exchange, plans on spending $16 million in federal funds and $8.8 million in state funds for outreach.” Because our governor opted against creating our own exchange the federal government has allocated only $1.5 million to NJ for outreach, and so far the state has not added any of its own dollars.
This lack of funding will affect participation in both our forthcoming Health Exchange and our Medicaid Expansion. As Seton Hall law Professor John Jacobi says, “People who are uninsured are typically very busy people who struggle to make their rent and put food on the table, and they are not engaged in the rollout of the ACA.” In the case of Medicaid expansion the new program will now be open particularly to more childless adults who will have to apply first for General Assistance. NJPP explains, “These individuals have many barriers to enrollment including mental illness, substance abuse, physical disabilities, homelessness, and an inability to speak English.”
As an essential starting point, Senate Bill S2644 increases the Medicaid income eligibility limit to 133 percent of the federal poverty level, consistent with the ACA. In committee, where the majority supported the bill, Diane Allen (R-7) did not vote, Dawn Addiego (R-8) abstained and Sam Thompson (R-12) voted no. To his credit Robert Singer (R-30) voted yes. It is important that this bill pass and that the Assembly act on it as well. The bill however, does not add state funding for outreach.
So our governor in a begrudging, half-hearted way has allowed the construction of a foundation for better health care opportunities for many in our state, but he has left us without the tools to complete the task. NJPP estimates that without outreach “New Jersey will lose $690 million in federal funds each year, and 186,000 fewer New Jerseyans will likely benefit from health care reform.” More funding for outreach is essential.