STATEMENT BY RAYMOND CASTRO, SENIOR POLICY ANALYST, NEW JERSEY POLICY PERSPECTIVE, ON A3186, TRENTON, NEW JERSEY
October 11, 2012
Thank you for the opportunity to comment on A3186. We are very supportive of this legislation to establish a health insurance exchange in New Jersey. We also want to thank you for expediting this legislation and passing the earlier bill on a timely basis.
There is much to be done for the state to be ready to accept applications starting next October, particularly in the area of outreach. The Congressional Budget Office estimates that the average participation rate for Medicaid and insurance exchange subsidies will be about 57 percent. But with enhanced outreach, that rate could be as high as 75 percent, according to an analysis by the Urban Institute.
In other words, if New Jersey does not move quickly and provide enhanced, intensive outreach, over 100,000 uninsured people will not obtain health coverage in 2014. Furthermore, up to $470 million will be lost in federal funding for Medicaid and exchange subsidies, not to mention millions in funds to plan the exchange.
We recognize that the Christie administration says that it will be “ready” to implement the Affordable Care Act, but New Jersey should be more than ready – it should be prepared to implement a model program with the goal of providing health coverage for everyone who is uninsured. We have done that for children in New Jersey FamilyCare, which has proven to be an enormous success. There is no reason we shouldn’t have similar expectations for the Affordable Care Act. In addition, this new effort is almost entirely federally funded and will result in major state savings.
To be ready for October 1, New Jersey should have a complete plan for enhanced outreach no later than February 2013.
The state has many questions to answer in its plan:
• What will be the qualifications for navigators?
• Who will train the navigators, who must have a thorough understanding of Medicaid and health insurance policy?
• What are the criteria or formula for distributing outreach grants?
• What community-based organizations will the state contract with?
• How can the state best reduce ethnic and racial health insurance disparities?
• How will community based organizations be reimbursed?
• What should be done in areas that lack effective community organizations?
Community input from all regions of the state in helping to answer these questions will be critical.
Once the major policy and programmatic decisions are made, the state must then finalize contracts with community-based organizations and they, in turn, must hire and train navigators. All of this should be accomplished by next summer to have the outreach program in place so that all uninsured New Jerseyans are aware of the opportunity and means to obtain health coverage well before the October 1 application date.
A3186 provides the opportunity to achieve this goal, but only if it is quickly enacted and fully implemented to go beyond the federal requirements and meet the growing health care needs of our state.
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