Legislation Expands FamilyCare for Uninsured, Moves NJ to Affordable Health Care for All
PERTH AMBOY – A bill sponsored by Senator Joseph F. Vitale which expands the FamilyCare safety net for uninsured New Jerseyans and takes the first step to ensure affordable health care coverage for all State residents was signed into law by the Governor today at a ceremony at Raritan Bay Medical Center.
“Today’s bill signing marks a commitment from the State of New Jersey – that we will not turn our backs on the 1 million working poor State residents who are one major health crisis away from bankruptcy,” said Senator Vitale, D-Middlesex, and Chair of the Senate Health, Human Services and Senior Citizens Committee. “With this new law, we are recognizing that the Garden State must spend its health care dollars smarter, and that the old system of reimbursing hospitals for providing emergency room care as a way to fund our obligation to the uninsured is dysfunctional and unsustainable. Through this law, we are saying that the dream of affordable, quality health care for all New Jerseyans is within reach, and that our State can be a national leader in providing access to appropriate care for the uninsured.”
“Every journey begins with a first step,” said David Knowlton, who worked with Senator Vitale on the health care reform plan and serves as President and CEO of the New Jersey Health Care Quality Institute. “Today actually marks a great leap forward for New Jersey on the road to health care reform. As I have said in the past, absolutely nothing will more quickly improve health care quality in our state than providing affordable and accessible health care coverage to those who now find it out of reach. In the near term, thousands of children in our state will see the quality of their medical care improved and in the very near future, all of our citizens will be able to say they reside in a state which treasures their health.”
The new law, S-1557, will expand eligibility for New Jersey FamilyCare to more low-income parents, as well as expand efforts to enroll uninsured dependents up to age 31 who meet current income standards into the program. Under the bill, parents earning up to 200% of the federal poverty level, or $42,400 in annual income for a family of four, will be eligible for health care coverage, up from the current level of 133% of the federal poverty level, or $28,200 in annual income for a family of four. This expansion of eligibility, paid for with $8 million in the FY 2009 Budget, will restore the FamilyCare program to the level of coverage it provided a few years ago, and will maximize federal matching funds for the program.
“With the FamilyCare program, we’ve seen that when parents have greater access to care, kids get enrolled too,” said Senator Vitale. “When families are trying to stretch every penny from their weekly paycheck, sometimes people view health care as expendable, and that goes for parents as well as children. However, we need to consider access to quality health care as a fundamental right for all Americans, not a privilege for those who can afford to think past soaring mortgage or rent payments and day-to-day living expenses.”
The bill will expand outreach and marketing of New Jersey FamilyCare for eligible uninsured dependents under the age of 31, and within a year of being enacted, all children age 18 and younger will be required to have some form of health care coverage, whether through public health care programs or private insurance. The bill does not set punitive measures for non-compliance, but the “Kids First” mandate will increase marketing of the program and work with schools, hospitals, clinics and the medical community to enroll many more children, with $1 million set aside to promote the program. Under current eligibility standards, children and adult dependents under 350% of the federal poverty level, or $74,200 in annual income for a family of four, are eligible for subsidized care, while parents whose family income is above 350% of the poverty level can purchase FamilyCare coverage for their children at the rate the State pays, based on an initiative unveiled late last year.
The bill also establishes a hardship waiver program for all or part of the premium payments in the NJ FamilyCare program for all enrollees. Waivers would be approved on a case-by-case basis by the Commission of Human Services, based on an application for a hardship waiver from a parent or legal guardian.
“The promise of NJ FamilyCare has never been fully realized, and a big reason for that is that while we have come a long way in providing affordable care, we need to do more to promote the program,” said Senator Vitale. “By engaging so many stakeholders in children’s health, we can get the word out to those who qualify for subsidized care. And by offering a hardship waiver, we can guarantee that no one will have to pay more than they can afford for health care in New Jersey.”
Finally, the bill will make various reforms in the individual and small employer insurance markets to ensure affordability and stabilize cost. The bill will require small business insurers to make a good faith effort to market individual policies, ensuring greater competition. The bill also establishes modified community rating to make health care coverage more affordable for young professionals who have historically forgone health insurance due to the high cost, and modifies the minimum loss ratio to ensure that a greater percentage of health care premium dollars is dedicated to direct health care costs, and not insurance administration.
“Ensuring affordable health care in New Jersey requires a soup-to-nuts perspective on the cost drivers for health care in the Garden State,” said Senator Vitale, who credited Assemblymen Louis Greenwald, D-Camden and Neil Cohen, D-Union for most of the market reform measures found in the bill. “We cannot focus solely on publicly-funded health care – just as we can’t focus on the private health insurance market – to adopt lasting and needed change in the health care system. This bill represents a balanced approach to the health care needs of our State residents, and will provide a stepping stone for future attempts to do more to ensure that everyone can afford the health care they need in New Jersey.”
The bill was approved by both the Senate and Assembly last month.