Burlington County Times

Advocacy Group Says NJ Consumers Can Still Renew Insurance Plans

Burlington County Times — Wednesday, December 4, 2013

By David Levinsky
Staff writer

A New Jersey consumer group says the thousands of state consumers with substandard "basic and essential" health plans that don't meet all the requirements of the national health care reform law can still keep their plans for another year if they renew before Dec. 31.

It's a little-known option that advocates with the New Jersey Policy Perspective believe should be publicized as one of the options available to consumers.

"It's not widely known, but you can already extend these policies, even the basic and essential ones," Ray Castro, senior policy analyst with the nonprofit group, said during a Wednesday conference call intended to dispel notions that consumers with substandard plans are being left without options.

President Barack Obama announced Nov. 14 that he would let states choose if they wanted to keep or cancel plans that don't conform to the Affordable Care Act, and Gov. Chris Christie's administration responded by announcing it would let New Jersey's insurance companies decide the fate of the approximately 800,000 individual and group plans that were slated to be canceled.

In making its announcement, the administration noted that many of the policies still would need to be altered to meet federal mandates, including that they contain no annual limits on coverage or caps, and those changes almost certainly would make them more expensive.

Horizon Blue Cross Blue Shield has announced it would not be able to renew 90,000 of its so-called basic and essential plans because they would have to be drastically modified to meet the Affordable Care Act's requirements. The state's other insurers offering low-cost individual plans also are not expected to be able to continue them.

A total of 110,000 consumers have substandard basic and essential plans, or roughly 1 percent of the marketplace.

Although those plans won't be renewed next year, advocates like Castro said they still can be renewed, but only if consumers act before Dec. 31. After that date, they won't be able to re-enroll.

Castro and others stressed that renewing substandard plans isn't necessarily the best choice for consumers, and most likely they would be better off shopping for more comprehensive coverage through the federal insurance marketplace, also known as the health care exchange, at healthcare.gov.

Although the plans available on the online marketplace may be more expensive than their existing substandard plans, consumers who obtain coverage with it also may qualify for subsidies that can bring the cost down.

Some consumers also could qualify for "catastrophic coverage" that includes all the protections mandated by the Affordable Care Act but at a more manageable cost.

"It's something that's available for anyone that can't access an affordable plan that costs them less than 8 percent of their income," said Maura Collinsgru, health policy advocate with the advocacy group New Jersey Citizen Action.

The problem, according to the advocates, is that most consumers aren't aware of their options.

Both New Jersey Policy Perspective and New Jersey Citizen Action want the Christie administration to use $7.6 million in unspent grant money it received from the federal government to publicize and educate consumers about the range of options available.

Castro said the state also should consider offering its own subsidies to consumers to make insurance more affordable.

Federal subsidies are available to individuals who earn up to $45,960 a year and families of four making up to $94,200. Castro said the state could offer additional subsidies to residents who fall outside those income limits in order to encourage more people, particularly healthy younger residents, to sign up for comprehensive coverage.

"We don't think a lot of consumers are aware of their rights and options," he said. "Most people don't want to keep plans that are inadequate, but they're very concerned about the costs."

Tom Vincz, a spokesman for Horizon Blue Cross Blue Shield of New Jersey, said consumers should contact sales representatives to sort through their options.

"We understand that consumers are being presented with many different options for obtaining health insurance. These options include buying a new, quality product through the online marketplace or direct-purchasing one of these products through HorizonBlue.com. Many consumers have also decided to retain their (Basic and Essential) and (Basic and Essential Plus) plans through their anniversary date in 2014 or to renew early, which could allow them to retain these plans through the end of next year," Vincz said. "We encourage consumers to contact one of our sales representatives, who can help them sort through the options and purchase a plan that best fits their needs and budget."

Meanwhile, state and federal lawmakers are seeking more information or pushing for the federal government to intervene and help maintain coverage for individuals in danger of losing their insurance.

The Senate Commerce Committee has scheduled a hearing Thursday afternoon to discuss the fate of nonconforming health plans and the impact cancellations might have. Members of Christie's administration have been asked to attend and provide testimony, along with representatives from the state's insurance companies, health policy experts and other stakeholders.

New Jersey Congressman Leonard Lance has written a letter to the U.S. Centers for Medicare and Medicaid Services asking it to step in and help insureds maintain health plans in danger of being canceled.

"Time is of the absolute essence. Thousands of New Jersey residents are scrambling this holiday season to ensure continued health coverage for families," said Lance, R-7th of Clinton. "The federal government should ensure that these New Jersey residents who like their health care plans are able to keep them and meet the president's promise."

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