As the COVID-19 pandemic has taught the country, access to health care is essential for all residents to lead a healthy life, protect public health, and build an economically and racially just future. While New Jersey outpaces other states in prioritizing access for all, newly released data on health insurance coverage from the United States Census Bureau show that the Garden State still has a long way to go in guaranteeing a healthy and equitable future.
New Jersey’s Uninsured Rate Increased for the First Time Since 2013
The number of uninsured New Jersey residents increased in 2019 from the year prior, according to newly released American Community Survey data. This represents the first increase in the state’s uninsured rate since the Affordable Care Act (ACA) was fully implemented, and is likely due to the Trump administration’s ongoing efforts to sabotage the landmark health law. Approximately 692,000 New Jerseyans were uninsured in 2019, representing a 6.8 percent increase in the uninsured rate from 2018. Residents under the age of 19 made up 88,000 of those uninsured in the state, representing a 10.3 percent increase in the uninsured rate for this age group.
These increases were not spread equally among all New Jerseyans. A hostile national environment toward people of color and immigrants, including the fear and uncertainty caused by the Trump administration’s public charge rule, have made it increasingly difficult to boost health care enrollment. In New Jersey, approximately 343,000 Latinx residents were uninsured in 2019, an increase of 7.5 percent in the uninsured rate from 2018. Residents identifying as Latinx, Black, or American Indian/Alaska Native remained the most likely to be uninsured.
Despite these challenges, New Jersey is still out-performing many other states in getting more residents covered. Nationally, 9.2 percent of people remained uninsured in 2019, a continuation of the increases experienced every year since 2016. While the Garden State’s uninsured rate (7.9 percent) crept closer to the national rate between 2018 and 2019, it remained well below that national average — and far below the state’s 2010 uninsured rate of 13.2 percent. New Jersey was able to expand health coverage thanks in great part to the implementation of the ACA. The state’s decisions to adopt many of the health law’s key provisions, particularly the expansion of Medicaid in 2014, have helped the state provide affordable coverage options. Similarly, New Jersey’s proactive decisions to codify key ACA provisions in state law — including the establishment of a reinsurance fund, banning junk plans, and restoring the individual mandate — helped protect these gains amidst the Trump administration’s ongoing efforts to undermine the ACA.
The COVID-19 Pandemic Promises Hardship … and New Jersey Needs to Prepare
New Jersey’s increasing uninsured rate must be viewed with careful consideration of the extraordinary conditions of 2020 that have yet to be captured by census data. With the COVID-19 pandemic, more individuals and families have been losing employer-based coverage, facing not only threats to their health but also to their economic well-being. This has been particularly true for people of color, who have fought the effects of structural racism that put them at greater risk for contracting, being hospitalized, and dying from the virus, in addition to facing more devastating and long-term economic repercussions.
In the Census Bureau’s most recent Household Pulse Survey — with data gathered between August 19th and 31st — over 8 percent of New Jersey respondents reported being uninsured, indicating a concerning increase from the 2019 estimates due to the pandemic. Without health coverage, people are unable to access needed care, a dilemma faced disproportionately by Black and Latinx residents in the state, according to the survey. The long-term health consequences of this lack of coverage will further exacerbate the overarching social and economic consequences of COVID-19 in the coming months and years.
There is hope, however. New Jersey has already seen that strong state action to protect the ACA and prioritize health care access improves outcomes. The 2014 Medicaid expansion in New Jersey has played a key role in dampening the overall effects of the COVID-19 crisis, as enrollment numbers have shown that the program has served as an important safety net for many residents who have lost employer-based coverage. Furthermore, Get Covered New Jersey, the new state-based health insurance exchange, opens for enrollment on November 1, 2020. With state subsidies available for those with incomes below 400 percent of the federal poverty level (annual income up to $51,040 for an individual or $104,800 for a family of four), the exchange will increase affordable coverage options for many of New Jersey’s populations who have suffered most during the pandemic.