Asbury Park Press

Watchdog Group Says Horizon Wants To Dump Medicaid

Asbury Park Press — Friday, November 21, 2008

By GREGORY J. VOLPE
GANNETT STATE BUREAU

Horizon Blue Cross Blue Shield of New Jersey disputed a watchdog group's claim Thursday that it plans to drop Medicaid coverage if state officials approve its application to convert to a for-profit company.

That was among the concerns raised by members of Horizon Watch Coalition, a group that has reconvened to monitor Horizon's conversion application, worried that people would suffer if the state's largest health insurer became responsible to shareholders, not communal interest.

Horizon spokesman Tom Rubino at first denied the claim. But then he added that if Medicaid is costing the company money, it could be dropped regardless of whether Horizon becomes a for-profit company or remains nonprofit.

"If a company can't make money in Medicaid, and is losing money in Medicaid, it can't do that for very long because other members are subsidizing that program," Rubino said.

Members of Horizon Watch Coalition said they want to make sure the state's review process is transparent, an independent consultant assesses health concerns and that proceeds to the state yielded by the conversation are used, as mandated by state law, to improve access to health care for the public — not to balance the state's budget.

Horizon filed its application in August, but state officials deemed it to be incomplete and returned it seeking more information. Horizon hasn't completed its response. Both Horizon and the state have posted their dealings online.

"They are certainly seeming to be transparent, but it's important this is not a back-room deal with public window dressing," said Eve Weissman of New Jersey Citizen Action. "Seeming to be transparent is one thing, actually providing the information is another."

Specifically, the group is concerned a conversion would limit access to health care, particularly for those with low or moderate incomes, wouldn't properly value Horizon's worth, wouldn't guarantee proceeds are free from political motives and that the decision would be spurred by monetary, not communal, interests.

The conversation could generate hundreds of millions, if not billions, of dollars toward health care in New Jersey by selling Horizon's stock. The company would have to reimburse the state for having relied on its tax status as its grew its business.

The company has estimated it is worth more than $1 billion, when other estimates have placed the figure between $3 billion and $8 billion.

Rubino, who met with reporters after monitoring the group's news conference, said the company largely agrees with the desires for transparency and having proceeds improve health care.

"This is the only way that billions of dollars can be freed up and the value of the company can be unlocked for the improvement of health care without raising taxes," Rubino said.

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