Wall Street Journal

In New Jersey, A Dash To The Health-Care Deadline

Advocates Make Last Attempt to Enroll Citizens Before Affordable Care Act

The Wall Street Journal — Thursday, March 27, 2014

By Josh Dawsey

NEWARK, N.J. — Over baked chicken, rice and sweet tea on a recent evening, advocates for the Affordable Care Act used detailed PowerPoint slides to sell health insurance in a half-full Baptist church ballroom.

The 50 or so people largely ignored the computer-wielding workers at the back who wanted to enroll them. The ballroom, available until 9 p.m., was nearly empty by 7:45.

"I would have hoped for more people, but it's the nature of the beast on these things," said Maura Collinsgru, a statewide health-policy advocate for the liberal New Jersey Citizen Action, who has shored up the enrollment push. "You can get discouraged if you look at one moment in time. You have to take the long view."

Gov. Chris Christie has made no secret of his disdain for the Affordable Care Act, calling it a "failed federal program" and receiving sustained applause after criticizing it at several town-hall events across New Jersey.

Yet in the final days of Affordable Care Act enrollment, a band of liberal activists, community groups and Democratic politicians is trying to prove him wrong, finishing a six-month crusade to drive citizens to the marketplace. They have enlisted U.S. Health and Human Services Secretary Kathleen Sebelius, who spoke behind an army of volunteers in Montclair, and Democratic Sen. Cory Booker, who lobbied the Latino community in Union City.

At a tax center in Newark, officials from Ms. Collinsgru's organization have set up tables to lure lower-income people while their taxes are being completed. Jersey City Mayor Steven Fulop has sent city workers into the community to knock on doors. As for more rural areas, activists said that many have received far less attention from volunteers.

"The lack of awareness is still pervasive," Ms. Collinsgru said.

Results have been underwhelming. Some 74,400 have signed up for private insurance in New Jersey, well below expectations circulated by nonprofit groups, according to the most recent data. And it isn't clear how many of those people already had policies. According to the last census report, the state has about 1 million uninsured.

New Jersey Policy Perspective, a left-leaning group, hoped 125,913 would sign up by March 31. Avalere, a national health-care consultancy, predicted 186,000, calculated from national enrollment projections by the Congressional Budget Office. As of March 1, the state had hit 40% of that projection—among the worst 10 states, according to an Avalere analysis.

Asked about New Jersey's lower-than-projected numbers, Ms. Sebelius said Monday that some confusion still exists about the law and that many would sign up in the remaining days.

Indeed, federal officials have said traffic to the marketplace nationally has risen recently. The White House said Thursday that more than 6 million Americans have enrolled, surpassing recently downgraded projections.

In the Garden State, like many other places, the health-care program has taken a hit in public perception. More than 50% want the law repealed, according to a recent Rutgers University poll.

Advocates criticized Mr. Christie for forfeiting about $7 million in federal funds to promote the exchange and not devoting state resources to enrollment efforts. Mr. Christie has said he wouldn't invest in what he deems a policy failure but has expanded the state's Medicaid program, unlike some Republican governors.

"We're all stymied by insufficient resources," said Raymond Castro, a senior analyst at New Jersey Policy Perspective, which supports the law. "It's very difficult. Everyone's trying harder in New Jersey because we don't have support from the state and the governor for the marketplace."

When asked for comment, Mr. Christie's spokesman referred to remarks the governor made in a March 13 town-hall event. Mr. Christie said he rejected the grant because Washington wouldn't allow his state to spend it in a flexible way he thought would best help New Jersey residents. In a letter to the federal government, his insurance commissioner proposed using at least some funds on things other than helping people enroll for health insurance.

Joel Cantor, a Rutgers University professor who has studied the Affordable Care Act, said its presence is "much more low-key" in New Jersey than some areas. "You don't see the bus billboards and the television ads and the signs like you do in somewhere like New York," he said.

And while federal dollars have funded "navigators" to help citizens enroll in the program, they are far fewer in New Jersey than in other places, said Ms. Collinsgru and others.

There are some successes, advocates say. The Medicaid expansion has brought more than 100,000 New Jerseyans into the program. At the recent Montclair event, officials touted individuals like Fawziah Qadir, a resident who signed up through the marketplace. "I'd never felt so much peace of mind," she said.

Ms. Collinsgru and her group have cobbled together much of that outreach, scoring grants from the Robert Wood Johnson Foundation and others. Community groups and leaders meet monthly, trying to schedule events. Workers from Enroll America, a national group, have also joined in the New Jersey effort, says Justine Ceserano, the group's state director.

Ms. Collinsgru has even taken her fight straight to the governor, urging him to support the health-care marketplace in a lengthy, loud argument after he called on her at a recent town hall. He appeared unpersuaded before heading back to Trenton. She went back to staging enrollment events.

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