Corzine Signs FamilyCare Legislation

PERTH AMBOY – Gov. Jon S. Corzine on July 8 signed legislation expanding NJ FamilyCare and establishing mandates for health care coverage of all children. The bill, S1557/A2624, also initiates a number of reforms to individual and small employer insurance markets.
“This is an historic day for health care in New Jersey,” said Corzine in a release. “While there has been much national dialogue about universal health care, here in New Jersey, we’re actually doing something about it.
“We’re expanding our best-in-the-nation FamilyCare program to cover more working-class families and requiring health coverage for all children in New Jersey. To do this, we will be phasing-in mandatory health care coverage to some 250,000 additional children and strengthening the FamilyCare buy-in option we recently offered for families earning up to 350 percent of the federal poverty level. Today is truly a giant leap on the road to universal healthcare coverage in New Jersey.”
Overall, the bill achieves several broad goals. First, it expands NJ FamilyCare to include more low-income parents. Second, it mandates that all children in the State have health care coverage through public or private means. Third, it increases affordability and stabilizes enrollment by individuals and small businesses. Fourth, it changes eligibility criteria, terms, and administration of continued dependent coverage for dependents 30 years of age or younger.
“With today’s bill signing, New Jersey is taking a dramatic step forward in ensuring that quality health care is a fundamental right – not a privilege – for all State residents,” said Senator Joseph F. Vitale, (D-Middlesex), the author of the plan to guarantee affordable health care coverage for all New Jerseyans. “The system of forcing the uninsured to seek costly emergency care, rather than see a doctor for regular medical checkups and preventive health care, is dysfunctional and unsustainable. We need to spend health care dollars smarter, and this new law puts us on track to get better health results cheaper for the 1.5 million New Jerseyans who are one major illness or injury away from bankruptcy.”
New Jersey’s FamilyCare program began as NJ KidCare in 1998. It was expanded and renamed NJ FamilyCare in 2000. Presently, parents in families of four must have incomes below 133 percent of the Federal Poverty Level to qualify or $28,196. There are more than 221,000 New Jersey children and adults covered, including 124,000 children and 97,000 adults. By expanding the program, it is anticipated that an additional 56,768 parents will be covered by the end of fiscal year 2011. During the same timeframe, it is anticipated that an additional 17, 149 children will become enrolled in the program.
“For too long families in New Jersey have been forced to rely on a healthcare plan that consists of not getting sick,” said Assemblyman Neil M.Cohen (D-Union). “Expanding access to FamilyCare and ensuring universal health coverage for children means that more individuals will have their small health problems treated before they can grow into life-threatening illnesses. This new policy is a huge step forward that not only will save the state money, but more importantly, will save lives.”
“Today, New Jersey continues down the road toward the goal of providing access to health care for all residents regardless of where they live or their economic condition,” said Assemblyman Louis D. Greenwald (D-Camden). “It is inexcusable that any child could be shut-out of a doctor’s office. It is inexcusable that a working parent cannot have access to an affordable health care plan. Through this investment in FamilyCare and the push for comprehensive market reform, we can ensure there will be no more excuses.”
Primary sponsors of the legislation in the Senate were Senators Joseph F. Vitale (D-Middlesex ) and Robert W. Singer (R –Burlington, Mercer, Monmouth, Ocean). Assemblymen Neil M. Cohen ( D-Union), Louis D. Greenwald (D-Camden ), Ruben J. Ramos, Jr. (D-Hudson ), John J. Burzichelli ( D-Salem, Cumberland, Gloucester ) and Paul D. Moriarity (D-Camden, Gloucester) were primary sponsors in the Assembly.
KEY REFORMS ESTABLISHED BY THE BILL:
Health Care Coverage
Provides a “Kids First” mandate requiring all children 18 years of age and younger to have health insurance coverage through an employer-sponsored or individual health benefits plan, the Medicaid program, NJ FamilyCare Program, or the NJ FamilyCare Advantage buy-in program. This coverage begins one year after the bill is enacted.
Makes health care coverage more accessible by expanding eligibility for the NJ FamilyCare Program to include parents whose income is between 133 percent and 200 percent of the Federal Poverty Level.
Prohibits hospitals from submitting charity care claims for emergency services
provided to patients under the age of 19 and presumes eligibility for NJ FamilyCare or Medicaid would be extended to these patients. Hospitals would be required to bill those programs for the cost of emergency care provided to the patient.
An ongoing enrollment initiative with the Department of the Treasury and the Department of Human Services (DHS) will be established as well as an enhanced NJ FamilyCare outreach and enrollment initiative to increase public awareness about enrollment.
Individual and Small Employer Health Insurance Reforms
· Implements health insurance reforms to make health benefit more affordable to individuals and small businesses in the State.
· Makes individual health benefits plans more affordable to younger persons, by revising the rating system for individual plans for new policies and contracts issued after the effective date of the bill.
· Requires carriers to offer and make a good faith effort to market individual policies as a condition of participation in the small employer market, in order to ensure greater participation by carriers in the individual market.
· Reduces the number of standard plans that a carrier must offer in the individual and small employer markets from five to at least three plans.
Dependent Coverage for Dependents 30 Years of Age or Younger Reforms:
· Makes changes to eligibility criteria, terms, and administration of continued dependent coverage for dependents 30 years of age or younger.
· Requires proof of prior, creditable health benefits coverage or receipt of benefits from another group or individual benefits coverage source to be eligible to elect or reinstate continued dependent coverage.
· Once an individual elects dependent coverage, that coverage is not ended until the individual reaches age 31. The cut off for electing coverage remains 30 years of age; the bill clarifies that the dependent coverage remains in effect while the individual is 30 years of age.
· Health insurers and the State Health Benefits Program (SHBP) must provide notice to the parents of dependents to increase awareness of continued dependent coverage
NJ FAMILYCARE BACKGROUND
· New Jersey’s FamilyCare program began as NJ KidCare in 1998. It was expanded and renamed NJ FamilyCare in 2000.
· The goal of the original legislation was to provide health insurance for low-income children whose family incomes were too high for them to be eligible for traditional Medicaid but also too low for them to be able to participate in a private or employer-sponsored health insurance program. The program is funded with State and Federal monies.
· By mid-2001, an all-time enrollment high of 180,000 adults enrollments was reached. With that NJ faced the challenge of running out of federal funding to support the parent piece of the program and as a result jeopardize the enrollment of children.
· In June of 2002, forced by budget concerns, New Jersey made the extremely difficult decision to stop enrolling parents and adults.
· On July 13, 2005 – five years to the date that the program first was expanded to include adults – the bill to reopen NJ FamilyCare to parents was signed.
· Presently, parents in families must have incomes below 133 percent of the Federal Poverty Level to qualify. This is $28,196 of the Federal Poverty Level and there are 97,563 adults covered.
· Jan. 1, 2008, we instituted NJ FamilyCare ADVANTAGE, the low-cost full buy-in program for uninsured qualified children of any income.
· In the SCHIP program, there are more than 221,000 New Jersey children and adults covered, including 124,000 children and 97,000 adults.
· Today, Medicaid insures approximately 1.05 million New Jersey children and adults. That includes more than 598,000 children and 453,000 adults.