Vitale-Morgan Introduce Reforms To Fulfill Promise Of Familycare

TRENTON – Senator Joseph F. Vitale and Assemblyman Robert Morgan, MD, announced today that they will make it a priority to reform New Jersey’s FamilyCare health insurance system in 2005, to increase participation and provide expanded coverage to New Jersey’s uninsured.

“New Jersey’s FamilyCare program is a boon to those who would otherwise be without hope, but frankly, it doesn’t go far enough,” said Senator Vitale, D-Middlesex, Chairman of the Senate Health, Human Services and Senior Citizens Committee. “Despite our best efforts under the current system, there are still more than 264,000 children in this State who remain uninsured. We need to dramatically change our current system of identifying and enrolling children, to live up to our commitment of providing health insurance to those in need.”

“The issue of affordable, quality health care in New Jersey is perhaps the most pressing problem confronting our State as we enter into the new year,” said Assemblyman Morgan, D-Monmouth and Mercer, who also practices pediatric medicine in Middletown. “Even those with secure employment find their coverage ever more compromised.”

After months of working with various stakeholders, including the New Jersey Council of Teaching Hospitals (NJCOTH), the Office of the Child Advocate, Legal Services of New Jersey, the Association for Children of New Jersey, the New Jersey Hospital Association, the New Jersey Association of Health Plans, and other committed advocates, the two legislators are proposing an overhaul of the FamilyCare system, which would streamline enrollment of eligible children, and extract administrative savings that would spend less on bureaucracy and more on health insurance for children and their families. Further, the proposal maximizes New Jersey’s investment in health care, by promoting preventive care, such as regular doctors’ visits which are covered under FamilyCare, versus episodic care, such as emergency room visits covered under the State’s charity care system.

“Last year, New Jersey hospitals delivered over $800 million in charity care services for uninsured patients, and an additional $400 million in unpaid care for patients whose income was slightly over charity care limits ($56,550 annual income for a family of four) but were unable to pay their bill. The State reimburses hospitals almost $600 million of that overall cost,” said Dr. Richard Goldstein of NJCOTH. “If we do nothing, in the next four years, we can expect the cost for charity care alone to rise to over $1.3 billion.”

Dr. Morgan agreed, noting that, “if we can promote healthy practices and get people to regularly see a family doctor, not just when they’re sick, but for regularly scheduled visits, we can contain and possibly even reduce the cost of charity care.”

“All of our kids deserve a healthy start in life,” said Kevin Ryan, the State’s Child Advocate. “These reforms are a gigantic step forward in that effort and I applaud Senator Vitale and Assemblyman Morgan for their leadership.”

The plan also calls for steps to secure additional matching funds from the federal government to expand FamilyCare and Medicaid health insurance coverage. Currently, the income cap to be eligible for Medicaid in New Jersey is 41% of the Federal Poverty Level (FPL), despite the fact that three of our neighboring States are all significantly higher: New York (150%), Pennsylvania (200%) and Delaware (117%).

“With the cap set so low for Medicaid reimbursement, we’re getting a lot less in federal matching funds than other States in the Northeast,” said Senator Vitale. “By making our cap comparable to other states in the region, we’ll be able to secure a stronger investment from the federal government for health care in New Jersey.”

The two legislators also pointed to the cost of the uninsured on employers and citizens in the State of New Jersey. According to a recent publication by the Institute of Medicine, the uninsured cost our State an estimated $2.9 billion annually in economic and social benefit due to lost productivity, reduced wages and higher incidence of disease. This exorbitant cost far exceeds the expense the State would incur to provide health coverage to this population and currently, the burden of this cost is shared among individuals, employers, health care providers and hospitals.

Supporters of FamilyCare heralded this reform package as a way to expand FamilyCare coverage to those currently going without health insurance in New Jersey.

“We applaud Senator Vitale and Assemblyman Morgan for this long-needed reform,” said Linda Garibaldi, Senior Attorney with Legal Services of New Jersey, a non-profit organization that provides free legal services to low-income New Jerseyans in civil matters. “For thousands of uninsured low-income families who are working one or more jobs and still cannot afford to see a doctor or get the medications they need, FamilyCare means they can get coordinated care and not have to wait until they have an illness that has reached a critical stage, when their only recourse is last minute attention in a hospital emergency room.”

“The key to good health is having health insurance,” said Michele Guhl, president of the New Jersey Association of Health Plans. “New Jersey’s managed care plans support efforts to enroll as many people as possible into Medicaid and FamilyCare and we are delighted that these reforms would help in our collective responsibility to reduce the number of uninsured in New Jersey.”

Gary Carter, President of the New Jersey Hospital Association (NJHA), said, “NJHA applauds the State’s commitment to the charity care program, and we applaud the State’s investment and recommitment to the FamilyCare program. The expansion and simplification measures included in this reform package will assist our hospitals in fulfilling their caring mission for the working families of this State.”

“Administrative problems have been barriers for children and families to access the FamilyCare program,” said Cecilia Zalkind, executive director of the Association for Children of New Jersey (ACNJ). “ACNJ supports proposals which will be effective in removing these barriers. We hope that in the future, FamilyCare will also be reopened to parents, since parental coverage increases the likelihood of child participation.”

“The business community has a vested interest in developing innovative solutions to the problem of the uninsured,” said New Jersey Business and Industry Association President Philip Kirschner. “Streamlining the FamilyCare program and reinvesting those savings in expanded opportunities for low income families to obtain affordable health insurance is a great benefit.”

Senator Vitale and Assemblyman Morgan said that they will introduce their FamilyCare reform package later in the month, when the Legislature reconvenes from winter break.

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