The Cutting Edge

Will Horizon Conversion Benefit New Jersey Residents?
There's Only One Way to Find Out

The Cutting Edge / Mental Health Association in NJ — Issue of December 2008

By Eve Weissman

As Horizon Blue Cross Blue Shield of NJ seeks for-profit status, New Jersey's consumers and taxpayers question whether conversion of the State's only non- profit health insurer is really in the public interest. Our state regulators — Commissioner Goldman and Attorney General Milgram — who are charged with overseeing and ultimately approving or rejecting the conversion must rigorously do the same.

Horizon is the oldest and largest health insurer in the State. Horizon provides health insurance to over 3.6 million New Jerseyans, constituting 46% of the State's insurance market.

It is government's obligation to ensure that the public's interest is adequately represented, promoted and served, especially for those who are most vulnerable including low and moderate income individuals and families, children, seniors, people with chronic and long-term illnesses, and people with mental and physical disabilities.

Will the conversion of Horizon result in New Jersey residents having more or less access to quality, affordable health care? To adequately answer these important questions the State must retain qualified, independent experts to conduct a thorough health impact study (also known as a "fairness analysis"). The health impact study must comprehensively evaluate whether Horizon, even as a non- profit, has adequately met the health insurance needs of New Jersey families, the impact of the proposed conversion on the health status of State residents, the ability of providers to negotiate payments with Horizon, and the impact conversion would have on insurance premiums, particularly in certain sub-markets such as Medicaid.

Many wonder, will our rates go up? Will we lose access to doctors and hospitals? Will deductibles grow larger? Will the same kinds of care be covered?

If conversion is approved, the full fair market value of the Horizon Corporation is to be placed in a non-profit foundation charged with expanding access to health care for New Jersey residents. So, how much is Horizon actually worth? It is the responsibility of the State to ensure New Jersey gets a fair deal. Estimates of Horizon's value range from just over $1 billion (Horizon's projection) up to $8 and possibly even $12 billion.

There must be public participation and transparency — including regional public hearings — in the conversion process. The voices of New Jersey consumers and taxpayers must be heard and we must be provided adequate information to evaluate the conversion, based on the potential impacts on our lives.

Conversion cannot be approved absent a health impact study and asset evaluation, both of which must be conducted by qualified, independent experts. Relying solely on Horizon's projections would put the interest of State residents in real jeopardy.

The recently re-convened Horizon Watch Coalition is a growing alliance of over 20 health care, consumer, labor, student, senior, faith-based, disability, civil rights and social justice organizations including NJ Citizen Action, the NJ Primary Care Association, Consumers Union, AARP NJ, CWA District 1, and HPAE. The Horizon Watch Coalition is working to ensure that the interests of New Jersey consumers and taxpayers — including Horizon policy holders and those both with and without health insurance — are represented and served as NJ considers Horizon's bid to go for-profit.

For more information and to learn about the Horizon Watch Coalition visit www.njforhealthcare.org.

Eve Weissman is the Health Care Campaign Coordinator, NJ Citizen Action. Contact: 732-246-4772 x22 or eve@njcitizenaction.org.

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