Statement of NJPP Senior Policy Analyst Raymond Castro on Governor's Health Insurance Exchange Decision

When Gov. Christie rejected the option of New Jersey operating its own health insurance exchange in November 2012, he hinted that he was not likely to partner up with the federal government in its operation. No surprise, then, that the governor has chosen to let the federal government be totally in charge of the exchange. No surprise, but it is disappointing.

The administration has had over two years and about $9 million of federal funding to study the ways to make an exchange work best for New Jerseyans. It has decided that not only should the federal government have primary responsibility, the state should have no responsibility. This hands-off policy is a big change for a state that under both Democratic and Republican governors has been in the forefront in protecting consumers and providing affordable health coverage to uninsured children, families and people with disabilities.

The decision puts New Jersey squarely behind the eight ball. Optimally, a November decision to make the exchange work for New Jersey would have smoothed the way for accepting applications from hundreds of thousands of eligible Jerseyans on October 1. The state would already be working to ensure that all eligible residents were fully informed, that outreach was underway to first-timers unfamiliar with insurance procedures, and that it would all be coordinated with the state’s Medicaid operations.

At least the long waiting game is over, and we know what it will now take to move a half million low and moderate income New Jerseyans closer to affordable health insurance via subsidized premium payments arranged over the exchange. Given the complexity of the challenge and the lateness of the hour, the governor’s decision to cede all authority for the exchange is probably the right one.

The Obama administration does not view helping the uninsured as a burden, but rather an historic opportunity to improve the health of struggling working New Jerseyans. It also will stimulate the state’s sagging economy as well and make it more competitive with its neighbors. The Obama administration has the technical knowledge and the benefit of working with other states that can result in a state-of-the art exchange for New Jersey.

There will still an important role for state government to play in this effort. New Jersey can cooperate with the federal exchange to offer one-stop shopping for Medicaid as well as premium subsidies. It will still regulate insurers in New Jersey and must make sure there are consistent polices both in and outside the exchange so insurers can’t game the system and cherry-pick consumers. State government runs almost all the programs that serve low-income people, such as food stamps (SNAP), so it can use those records to help reach those who do not have insurance.

The public must be involved too. Studies show that the uninsured are most likely to listen to their family and friends in deciding whether to seek health coverage. All of us must do what we can to improve the health of our loved ones and make our nation stronger.

As for New Jersey Policy Perspective, we look forward to working with the Obama administration on New Jersey’s health insurance exchange. We hope that outreach to the uninsured and under-insured begins as soon as possible, with the goal improving health care for those now denied quality coverage.

One Comment

  1. Irwin Stoolmacher February 18, 2013 Reply


    When must NJ make a decision on medicaid expansion? Do you feel based on the Governor’s decision not to create in-state exchanges,that he will to cap medicaid spending? Like to discuss this with you when you have time.

    Irwin Stoolmacher

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