Christie Makes Reluctant Decision To Expand Medicaid

The Record ( — Tuesday, February 26, 2013

The Record

Governor Christie's reluctant decision to expand Medicaid was embraced by supporters of President Obama's health care reform, even as he warned he would change his mind if the federal government failed to provide the promised funding.

The governor said his plan will bring 104,000 citizens who have not been eligible for Medicaid coverage into the program next year. They "are consistently among those who need help the most - men and women who have suffered trauma in their lives, live with mental illness, rely on New Jersey's emergency rooms for primary health care needs, or those citizens who lack insurance or access to treatment in other ways," Christie said.

Others who haven't enrolled, but are already eligible, are expected to sign up when the new health law takes effect. And the federal government will pick up the state's share of the cost of insuring some parents of children who are currently in NJ FamilyCare, a subsidized insurance program for those with slightly higher incomes. All together, that will bring total enrollment in the expansion to between 200,000 and 300,000, state officials estimated.

Among those who lauded the decision, which the governor announced in his annual budget address Tuesday, was state Sen. Joseph Vitale, D-Middlesex.

"It was smart," Vitale said "It makes sense. I've been saying that for many months. It doesn't cost the state any money. Over the long term it will save a lot of money and save lives. It's the right thing to do."

Douglas Johnston of the state chapter of AARP said: "This is especially good news for our fellow residents who continue to struggle in today's difficult economy or who are still digging out from superstorm Sandy. A significant portion of the adults newly eligible for coverage will be between the ages of 50 and 64, he said.

The program until now has not been available to childless adults. It will be extended on Jan. 1 to all adults with incomes up to 133 percent of the poverty threshold, or about $15,280 a year. Savings to the state from federal subsidies will total $227 million, he said.

Christie became the 23rd governor nationwide, eight of them Republicans, to agree to the expansion. It was originally envisioned as a required part of federal health care reform, but a Supreme Court ruling last year left it to the states to decide whether they wanted to participate in the Medicaid expansion.

The 23 states that have opted for expansion account for more than half of the U.S. population, according to one analyst. Only 10 governors are left to declare their plans.

Christie's long-awaited announcement came after days of advocacy work by a coalition including labor, retirees, Hispanic groups, progressive activists, and some religious organizations. They greeted the decision as a victory of pragmatism over ideology.

But in his speech, Christie was adamant that he remains against the other reforms that come with Obamacare.

"Let me be clear, I am no fan of the Affordable Care Act," Christie said. "I think it is wrong for New Jersey and I think it's wrong for America."

He agreed to the Medicaid expansion, he said, because now that health care reform is "the law of the land," his plan "will ensure New Jersey taxpayers will see their dollars maximized." Not to claim the federal subsidies would mean the funding would go elsewhere, he said.

Christie's decision and the warm reception it received left Steve Lonegan, state director of Americans for Prosperity, a Tea Party-related group, unhappy.

"It was a huge disappointment," Lonegan said. Alluding to softened opposition by the Republican governors of Florida, Virginia and Ohio to Obama's plan, he said, "The expansion of Medicaid is really a setback. The way it's happening between Rick Scott and Bob McDonnell and John Kasich, it's a setback for the conservative movement."

But policy analysts said Christie's decision made sense in terms of health care and the budget.

"It's a win-win for the state," said Joel Cantor, director of the Rutgers Center for State Health Policy. "More people have coverage and the state saves money. Why would you not do that?"

Rep. Frank Pallone Jr., D-Monmouth, also welcomed the decision.

"Medicaid expansion will not only improve New Jerseyans access to affordable health care, it will improve our economic health as well," he said. "With all of New Jersey's pressing needs right now, it is assuring that this assistance will help us to devote more resources toward building our economy and creating jobs."

The state's hospitals also were pleased at the Medicaid news and at the governor's continued commitment "to preserving current levels of charity care funding and increasing support to teaching hospitals," said Betsy Ryan, president of the New Jersey Hospital Association. Last year, hospitals provided about $1.3 billion in care to the state's uninsured, she said.

Dena Mattola Jaborska of New Jersey Citizen Action said: "Who will benefit? Hardworking people in food service, day care, construction and more who do not earn enough to buy health insurance, victims of Hurricane Sandy who have lost their jobs, college graduates who have been unable to find full-time work, and adults over 50 who have lost their jobs and are not yet eligible for Medicare."

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