Quality Institute and Sen. Vitale Will Engage New Work Group to Create Plan

The newly installed Congress quickly took action to start repealing the ACA. But then the reality set in. Up-ending such a vital, complex and far-reaching system will not happen overnight. Now we’re hearing less about “replace” and more about “repair” by the end of the year, or thereabouts. While this pause to reflect is positive, there nonetheless is no time for New Jersey to waste.

Our fragile marketplace, where individuals can purchase health insurance, had challenges even with the ACA and the subsidies to help people afford premiums. Yet going back to our pre-ACA individual market is no solution, either.

Even as the federal landscape remains uncertain, New Jersey can move forward with plans to improve health insurance coverage for people in our state. We can make sure we’re prepared if the federal government returns the responsibility of health insurance to the states. In New Jersey, we have the experience and experts right here. Starting in 1994, we already had a marketplace for individuals to purchase insurance — a marketplace with many of the same protections provided by the ACA.

Two weeks ago, state senators urged Governor Christie to work to preserve the Medicaid expansion as well as other gains created by the ACA. Senator Joe Vitale also announced that in the first quarter of this year, in partnership with the New Jersey Health Care Quality Institute, he will create a multi-stakeholder work group to design New Jersey’s plan for Health Care Coverage for All. I will lead the group along with Senator Vitale.

There is powerful precedent here. The Quality Institute and Senator Vitale worked closely in 2007 and 2008, before the passage of the ACA. We brought the right people together and created a plan that significantly reformed our health insurance markets and expanded NJ Family Care. Senator Vitale plans to continue with that working model as we move forward, not backward, and bring about Health Care Coverage for All.

We plan to start soon. Together, we’ll be reaching out to a range of people from all sectors along with subject matter experts willing to give of their time and talents. We also look forward to engaging our members in finding solutions that keep New Jersey residents healthy, safe and covered. The stability of our health insurance market, our health care delivery system, and the health of our residents are at stake.

The first step forward is to create the pillars essential to any New Jersey ACA replacement:

• Continue insurance coverage for the 750,000 plus people newly enrolled as a result of Medicaid expansion and the ACA premium subsidies and supports on the Marketplace.

• Reduce the uninsured rate even more to assist the 8.7 percent of NJ residents who remain uninsured.

• Move to reinstate or amend rules, as needed, to ensure that there is a place next fall for people to buy health insurance for 2018 and beyond that does not discriminate based on gender, health status, or pre-existing conditions.

• Make sure that insurance products sold in NJ comply with the anti-discrimination and consumer protection standards that our residents rely upon.

• Find funding solutions and cost control strategies that make premiums affordable in the NJ Individual Market, including making sure that everyone participates in the market, that large employers provide insurance to their employees, and that there are no free riders.

• Ensure that if the ACA is repealed, NJ individuals will still have a web-based Marketplace platform and market transparency tools to assist them in choosing the plan that best fits their medical needs and budget with information on pricing, drug formularies, and network directory detail.

When we last worked with Senator Vitale and others to craft Health Care Coverage for All in New Jersey our goal was aspirational. We came very close to having every resident of our state have health insurance. We cannot slip back and allow people to lose health care coverage, which is a basic human right, and, for many, truly lifesaving.