TRENTON – Citing a recent report by the State Auditor which detailed how some high-wage earners were able to take advantage of the health care benefits offered to uninsured low- and middle-income families, Senator Barbara Buono today announced the introduction of a measure to ensure greater safeguards and income verification for New Jersey FamilyCare and Medicaid.
“We need to make sure that only those applicants who qualify for FamilyCare are enrolled in the program,” said Senator Buono, D-Middlesex. “Nearly 1.25 million people in New Jersey are uninsured, including 240,000 children. With a finite amount of State dollars dedicated to provide subsidized health insurance programs, strict oversight and transparency are essential.”
Senator Buono’s bill would strengthen income eligibility verification in Medicaid and NJ FamilyCare to ensure that only qualified families would be able to collect the health care benefits offered by those programs. The bill amends the application and renewal requirements to require an applicant to submit a recent pay stub, indicating their annual income. Under the current law, “no more than one” recent pay stub is required from each applicant, but that clause has been misinterpreted by the program to mean that a pay stub is not required to establish eligibility.
“Essentially, by failing to require a recent pay stub be submitted, these programs have taken applicants at their word that they qualify for subsidized health care,” said Senator Buono. “Given the abuse outlined by the State Auditor, we need some sort of proof of income as a term of eligibility.”
The bill also requires the Commissioner of Human Services to establish guidelines for internal auditing and oversight, and to work with the Department of Labor and Workforce Development, as well as the State Treasury, to match applicants to their State income tax records and other State records. The current law does not require – but simply permits – the Commissioner to establish any auditing and oversight procedures or match applicants reported income with records from the Treasury and the Department of Labor.
“My office receives numerous phone calls from people attempting to apply for FamilyCare, only to find that the program is no longer accepting applications or they do not fall within the income guidelines by a small amount,” said Senator Buono. “When we do not have enough funding to provide assistance to families who legitimately need it, and others are earning six figures and claiming poverty to qualify for benefits, there’s something very seriously wrong in this program.
Senator Buono noted that the current law needs to be changed to ensure that proper oversight and monitoring mechanisms are in place before State dollars are expended improvidently.
“We must strive for more accountability,” said Senator Buono, the Chair of the Senate Budget and Appropriations Committee. “This year’s very difficult budget should make it apparent that New Jersey government must operate at maximum efficiency, and the abuse outlined by the State Auditor is an example of the chronic problems facing State budgets in the past. Safeguarding our State’s health care investment, and ensuring that funds are spent appropriately, will be a priority in this year’s budget deliberations.”