Tag Archive: Joe Vitale

Players in the Life and Death Game Of The Affordable Care Act

There are about 1.3 million people in NJ without health insurance – people who forgo needed doctor visits, can not afford medicines, avoid surgery, receive short term help in emergency rooms, and die earlier than those insured. One would think that such a large group would have a significant voice in NJ’s approach to the Affordable Care Act (ACA). Alas!… no way.

There is the Republican approach which is to “repeal and replace Obamacare” and the Democratic approach which is to implement a NJ health exchange with consumer friendly rules and participate in Medicaid expansion. While political dogma will play a role and there are strong consumer advocacy groups, there is also a handful of high-powered industry lobbying organizations with money and access who will influence the outcome. Governor Christie, who boasts he is not shy about stating his position, has yet to enunciate with any clarity where he stands. Unfortunately, there is little time to meet the deadlines – the first of which is just two weeks after elections, to notify the federal government whether NJ plans to build its own healthcare insurance exchange.

Below are key players and oversimplified explanations of their positions, primarily on the type of health exchange needed for NJ. The players do not always publicize what they are seeking and may take different tacks as matters progress. The devil is always in the details.

NJ Association of Health Plans – NJAHP represents the six NJ health insurers. While members of this group like the idea of adding more patients to their rosters and they support a NJ health exchange, they want a “passive model” based on allowing all NJ insurers to participate under the minimum federal regulations, as opposed to facing additional state requirements which might be more consumer friendly – the “active model.” This disagreement was one of the reasons Governor Christie vetoed Senators Nia Gill’s (D-34) and Joseph Vitale’s (D-19) more progressive “active model” health exchange bill (S551).

Medical Society of New Jersey (doctors) – MSNJ did not support ACA legislation largely because “it did not address the sustainability of the Medicare and Medicaid programs and tort reform.” Doctors in NJ for Medicaid are reimbursed at a low rate of 37 percent of the federal Medicare rate, compared with a national average of 72 percent, and see little advantage in expanding Medicaid. More recently MSNJ has stated support for a NJ health exchange.

NJ Hospital Association – NJHA supports the goal of ACA to create health insurance exchanges. Hospitals receive monies from the State for charity care (this year $665 million) which they always consider insufficient. More patients with health insurance would decrease charity care and increase hospital revenue.

For other players, both pro and con, go beyond the fold.

The NJ Politics Of The Affordable Care Act

Yesterday’s ruling of the Supreme Court brought jubilation to supporters of the Affordable Care Act (ACA). Raymond Castro (NJPP) points out, “As of 2010, there were over 1.3 million New Jerseyans without health insurance; that number has been growing at a much greater rate here than it has nationally (55% v. 35% since 2000)” Federal subsidies in the ACA have the potential to bring health care to an additional uninsured 800,000 New Jerseyans through a NJ  health exchange and Medicaid expansion. However, such may not come to pass in our state where Governor Christie is not only a Republican but courts the good will of national Republicans and their candidate Mitt Romney. For Republicans the mantra is “Repeal and Replace” not expand.

Health Exchange

Christie vetoed the bill championed by Sen. Nia Gill (D-34) and Joseph Vitale (D-19) creating a NJ Health Exchange. Christie said he wanted to wait until the Supreme Court determined whether the Affordable Care Act was constitutional. Following yesterday’s ruling he said he would meet any deadlines imposed on the state. But on his monthly radio call-in program on 101.5 FM last night, he called the Supreme Court decision “a screwy opinion,” and promised to again veto the bill which Democrats in the Legislature now want to re-introduce.” So he does not like the exchange concept, ACA, nor the State bill, but he has made clear he will implement a Health Exchange. The deadline calls for enrollment to start by October 2013 and coverage to begin by January 2014.

Failure to comply would result in the Federal Government setting up its own exchange here which Christie has said he does not want. Plus, the State would lose up to $19 billion in subsidies for the exchange. Senator Vitale has said the “bill can be amended to address some of the concerns the governor has.” However, sooner rather than later the Governor will have to complete the implementation process. Even Lonegan/Kochs’ Americans for Prosperity, which has established as a top priority defeating any such exchange, will be unlikely to succeed in its goal. NJ Has already received about $9 million in federal grants to set up the exchange.

Medicaid Expansion

ACA provides subsidies of $22 billion to NJ to expand the Medicaid program for low and moderate income people. However, the Supreme Court ruled that states can opt out of the Medicaid expansion piece and not forfeit Medicaid funds. Under current Republican dogma any expansion of what they (and NJ Today) call “Obamacare” is anathema. In spite of the fact that the first three years of the plan would be paid for entirely by the Federal government, Christie may choose to salute the Republican flag and decide not provide healthcare to our poorest residents.

Last year in February Gov. Christie vetoed a bill that would have expanded the Medicaid program to more women seeking family planning services. Later in the year he nixed a plan that would have cut Medicaid coverage for thousands of N.J. residents. Also, he did not join 26 other states in suing the federal government over ACA. Following the ruling Christie has not made clear what his position is on Medicaid expansion. He now has more latitude to opt out of it, but we will have to wait and see.  

Who Gets the Gavel?

promoted by Rosi

The new Senate committee lineups are taking shape and I just got my hands on the list of committee chairmen/women. Some seem like a natural fit (Vitale, Scutari for ex.) while other appear wildly out of place given their backgrounds and leadership skills. But that’s just my take.

Anyway, follow me below the fold to learn who the Senate’s gavel-bearers will be for the next 2 years.

I Believe The Governor is a Good Husband and Father. I Just Don’t Believe He’s A Good Governor!

For The New Jersey Family.

Twas a good convention. I was moved by speeches given by Chair John Wisniewski, our Senator Frank Lautenberg and most notably the one passionately delivered by Speaker Sheila Oliver. The theme of all was: remember why we’re Democrats, and go back to the grass roots who share our values. Young people, candidates, vendors and many interesting folk in attendance. The breakout sessions were informative, and meeting other Dems was most satisfying.  Made some great connections with other women throughout the state who want to help with the womens’ access to health care issue. Also enjoyed meeting some of the very famous Blue Jersey bloggers in person. They were all over the convention. Rosi, with her trusty computer, kept all of you up to date in real time.

But why do some in our ranks continue to try to plant negative stories with the press? Not designed to help anyone!

Along with the Women’s Political Caucus, we hosted the Women’s Health Roundtable in Trenton this past week. Very well attended and representatives of the various groups including nurses and other health professionals, womens’ organizations, and providers were outspoken in describing what the cuts to these health programs mean for women and their families. Thanks to Jay Lassiter for being there with his camera. I did describe the Governor as having initiated a “war on women”. Mike Drewniak, Gov’s press secretary, responded with: ‘that’s over the top – everyone knows Chris Christie is a loving husband and devoted father to two daughters’.  I would assume that’s very true, and would only add: And they have very good health insurance and access to health care!  more below…

“Vote of no confidence” in Wisniewski, from entire Woodbridge delegation at MCDO convention

Tonight, at the Middlesex County Democratic Organization (MCDO) convention, John Wisniewski got some measure of comeuppance for the leaked redistricting map that would have required two of the state’s most progressive Senators, Barbara Buono and Joe Vitale (both of Middlesex), to compete against each other, and carved an opportunity for Wisniewski himself to move up to the Senate. Progressive outrage after that leak rose within hours; multi-level and very public. The map, rumor had it, could be attributed to Wisniewski himself and what looked like opportunism fueled that mobilization. At this evening’s gathering of Middlesex Dems, that common perception of what happened during redistricting nearly cost John Wisniewski, state party chair and a candidate in November, the line. In his own re-election in his own home county party.

When Alan Rosenthal threw his vote behind the map proffered by the Democrats, there was jubilation in Party circles, high-fives for NJDSC Chair & redistricting co-Chair Wisniewski and a palpable air of self-satisfaction that the Democrats made Christie – who had poked his executive branch nose deep into the legislative branch’s process – lose something.

But what is a score for Democrats is not necessarily the same kind of score for progressives. There are different measuring sticks and the priorities are for more than party loyalty and a sunnier outcome for Democrats. From an infuriating Senate vote against marriage equality, to a too-cozy relationship between Chris Christie and sometimes-helpmate Democratic Senate President Sweeney, there is a sense that the Democrats have not done enough with their majority. And so it was that when that map leaked there was a one-day, multi-level, ferocious and very public expression of outrage from progressives in defense of Buono – an obvious contender for governor – and Vitale. (Disclosure, several members of the Blue Jersey staff were involved).

But while that was going on, the leaked map had what I think is a separate impact on local Democrats loyal to their own in Vitale and Buono, people they’ve worked alongside and helped develop. And so, there was actually discussion among the Buono and Vitale camps to organize to deny Wisniewski the line tonight. But, maybe because longtime MCDO Chair Joe Spicuzzo was just arrested a month ago on corruption charges something many shades less extreme took place.

In the end, the entire Woodbridge delegation abstained in a vote to endorse Wisniewski for re-election, minus Woodbridge mayor John McCormac, who is not on the county committee and didn’t vote, but made clear their position:

Woodbridge is a team, and Wisniewski’s actions threatened our teammate [Vitale], and we don’t appreciate that. It was symbolic, but it was essentially a vote of no confidence.

It remains to be seen what fissures tonight’s vote revealed or opened. Wisniewski played it all down: “Middlesex County’s fine. I don’t think there’s any lack of cohesion in Middlesex County.”