The Star-Ledger

New Jersey Fights To Save Obamacare Protections

The Star-Ledger — June 17, 2018

Maura Collinsgru
Guest Columnist

Under the Affordable Care Act, New Jersey expanded affordable health care to more than 800,000 of its residents. Millions more benefited from the guaranteed protections that prohibited discrimination in setting premium prices based on age, gender or pre-existing conditions and requiring health plans to cover essential health benefits. New Jersey's uninsured rate fell by a whopping 34 percent and premium increases had begun to stabilize.

But under the Trump administration, that progress and those protections have come under attack. Early this month, the Department of Justice challenged key provisions of the Affordable Care Act, including those protecting people with pre-existing conditions. This action could impact some 3.8 million New Jerseyans, and is another in a long line of Trump administration ACA sabotage actions that threaten our nation's health care.

Gov. Phil Murphy made a pledge to stand up against such attacks, and so far his actions have not disappointed. New Jersey's attorney general joined 16 other states opposing a motion by red states to halt operation of the ACA. But nothing signals the governor's commitment to safeguard our health insurance market more than the two bills he recently signed. One reinstates the individual-mandate penalty recently repealed by congressional Republicans as part of their federal tax cut plan. The other will establish a reinsurance program to offset the most costly enrollees.

Individuals who can afford health insurance coverage will be required to maintain it or pay a penalty. If the cost of insurance exceeds about 8 percent of an individual's income, the penalty will be waived. Those paying the penalty will be advised of their options under the ACA and encouraged to enroll. The goal is to incentivize younger, healthier people and the uninsured to get covered. When they do, we all benefit. Risk is spread out over more people and premiums stabilize. Without the mandate, people will put off buying coverage, the risk pool shrinks and becomes unhealthier, causing prices to increase for everyone.

Meanwhile, a reinsurance program will provide payments to health plans that insure excessively high cost individuals. Offsetting the expense of these high-cost individuals will provide another safeguard against premium increases in the individual market.

Murphy has taken other actions to safeguard health care for state residents. New Jersey also will assume responsibility for reviewing health plans sold on the health insurance exchange — something the feds were doing. This gives New Jersey more authority to ensure that plans comply fully with our state laws, which are increasingly stronger than federal requirements. This also leaves New Jersey poised to take over the exchange if that ever becomes the better option.

The Murphy administration also will leverage more state resources than its predecessor to help promote enrollment through the ACA marketplace.

There is still work do, but this is all a great start. New Jersey Citizen Action and our partners in the NJ for Health Care Coalition support the governor and Legislature in their efforts to protect consumers and contain health care costs to make quality, affordable health care available to all New Jerseyans.

Maura Collinsgru is health care program director for New Jersey Citizen Action.

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