N.J. Readies Vote On Health Insurance Market As White House Unveils Exchange Blueprint — Tuesday, March 13, 2012


WASHINGTON — The Obama administration on Monday finalized an ambitious blueprint for new state-based health insurance markets that will offer consumers one-stop shopping along the lines of

It may sound simple, but getting there will be like running an obstacle course. The rule comes just two weeks before the Supreme Court takes up a challenge to the constitutionality of the law in a case brought by states. Many governors and legislators are on the sidelines awaiting the outcome, even as time is running out to act.

New Jersey has 1.3 million uninsured residents. A bill to create a new health insurance market called an "exchange," a version of which must be up and running in every state by Jan. 1, 2014, is slated for a vote by the full state Senate on Thursday and is expected to be posted the same day in the Assembly.

The exchanges are the linchpin of a grand plan to make health insurance accessible and affordable to those who now struggle to find and keep coverage. Individual consumers and small businesses will be able to shop online for competitively priced coverage, and many will receive government subsidies to help pay premiums.

"More competition will drive down costs and exchanges will give individuals and small businesses the same purchasing power big businesses have today," Health and Human Services Secretary Kathleen Sebelius said in a statement.

A coalition of consumer groups plans a press conference today to rally support for the passage of the bill to create New Jersey's exchange. The group includes New Jersey Citizen Action, AARP, NJ PIRG, the NJ Public Health Institute, NJ Policy Perspective and Advocates for Children of New Jersey.

"The number of uninsured has been increasing every year in New Jersey from 2000 to 2010," said Jeff Brown of New Jersey Citizen Action. "We really need a solution to this growing problem, and we need a solution that makes sense for New Jersey."

A spokesman for Governor Christie could not be reached Monday night.

The health care law is expected to enable 550,000 of New Jersey's 1.3 million uninsured residents to buy insurance. Some of them will have subsidies to purchase their insurance on the state exchange.

Some aspects of the measure, introduced by state Sens. Joe Vitale and Nia Gil and Assemblyman Herb Conaway, have generated conflict. They include the composition of the exchange's governing board and the role of the exchange in vetting the insurance offerings.

Last month, the state Department of Banking and Insurance received a $7.7 million federal grant to plan for the implementation of the exchange. Acceptance of the grant did not signify a commitment to actually open the exchange, said Marshall McKnight, a state insurance department spokes-man.

Experts say it is anybody's guess how the national rollout will go. If a state is not ready, the law requires the federal government to step in to run its exchange. But the Obama administration's request for $800 million to operate federal exchanges has gotten a frosty reception from congressional Republicans.

"At this point it's still an open question as to whether all the states will open up as of 1-1-2014," said Neil Trautwein of the National Retail Federation, a business group whose members will be heavily affected by the law.

Reaction on Monday to the 640-page rule was mixed. Consumer organizations, the insurance industry and some business groups gave it favorable or neutral reviews. Republican governors panned it.

The new markets are for individuals and small businesses buying plans. Most people who now have employer health insurance will not have to make changes. It's a design that works well in Massachusetts, where an exchange has been in place for several years.

Massachusetts achieved political consensus about its health care overhaul under former GOP Gov. Mitt Romney, who is now seeking his party's presidential nomination. That's far different from the enduring national divisions over President Obama's law, even though it used Romney's as a foundation.

Setting up 50 state exchanges wouldn't be easy even if the federal overhaul enjoyed widespread support.

For things to go smoothly, state and federal officials must work together to verify private personal and financial details for millions of people, make sure that consumers are enrolled in the right health plan, and accurately calculate how much government aid, if any, each household is entitled to.

And with customer service the goal, consumers need to get answers in hours, not weeks.

Nearly 30 million people are eventually expected to get private health coverage through exchanges, about half of whom are currently uninsured.

Another group of uninsured people — as many as 16 million low-income Americans expected to qualify for Medicaid — could also enter the system through their exchanges.

States are moving in fits and starts to set up the new markets. Only 13 states and Washington, D.C., have adopted a plan. Progress varies widely among the rest.

Under the law, most Americans will have a legal responsibility to carry health insurance, either through their job, a government program or by buying their own. Millions will receive financial assistance for their premiums.

Whether that amounts to an unconstitutional expansion of federal power is among the subjects of a showdown that begins March 26, when the Supreme Court is set to begin an unusual three days of arguments. A decision is expected by June.

Sebelius says she expects the court to uphold Obama's Affordable Care Act and thinks states will move quickly once the court has ruled.

Staff Writer Lindy Washburn contributed to this article.

Copyright 2012 North Jersey Media Group Inc.

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