FamilyCare Expansion Bill Clears Legislative Hurdle

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Measure Would Set Stage for Affordable Health Care for All NJ Residents

TRENTON – A bill sponsored by Senator Joseph F. Vitale which would expand eligibility and outreach of New Jersey FamilyCare in order to set the stage for affordable health care for all New Jersey residents was unanimously approved by the Senate Health, Human Services and Senior Citizens Committee on May 15.

“New Jersey is in the midst of a health care crisis, and the skyrocketing cost of care is driving more residents to neglect their health in order to meet other basic human needs,” said Vitale, D-Middlesex, and chair of the Senate Health Committee. “No one should have to choose between food, shelter and health care, particularly when nearly six hundred people die every year because they’re uninsured. We make a substantial investment in health care for the uninsured already, and we need to seek a better, more efficient and more effective model to provide preemptive care to those in need.”

The bill, S-1557, would expand eligibility of New Jersey FamilyCare to more low-income parents, as well as expand efforts to enroll uninsured children who meet current income standards into the program. Under the bill, parents earning up to 200% of the federal poverty level, or $42,400 in annual income for a family of four, would be eligible for health care coverage, up from the current level of 133% of the federal poverty level, or $28,200 in annual income for a family of four. This expansion of eligibility would return income eligibility standards for the FamilyCare program to the level they were at a few years ago, and would maximize federal matching funds for the program.

“As we face a massive budget shortfall this year, we recognize that we need to make the most of federal funds across the board that are made available to fund state programs,” said Vitale. “When we scaled back the eligibility of FamilyCare a few years back, we made a big mistake, both in terms of losing out on federal matching funding and denying coverage to the working poor who needed access to quality care. I’m happy to say that through this bill, we’re recognizing that the rollback of FamilyCare was bad public policy, and are taking the steps to correct that mistake.”

The bill would expand outreach and marketing of New Jersey FamilyCare for eligible uninsured children under the age of 18, and within a year of being enacted, all children would be required to have some form of health care coverage, whether through public health care programs or private insurance. The bill does not set punitive measures for non-compliance, but the “Kids First” mandate will increase marketing of the program and work with schools, hospitals, clinics and the medical community to enroll many more children, through automatic enrollment at the point of care and application forms sent out with income tax returns for uninsured eligible residents.

Under current eligibility standards, children under 350% of the federal poverty level, or $74,200 for a family of four, are eligible for subsidized care, while parents whose family income is above 350% of the poverty level can purchase FamilyCare coverage for their children at the rate the state pays, based on an initiative unveiled late last year.

“Right now in New Jersey, there are nearly 200,000 children who are eligible for FamilyCare coverage who are not enrolled,” said Vitale. “We need to do more to get out the word about eligibility, and ensure that children receive access to the care they need to grow up to healthy adults. FamilyCare does little good if it remains the state’s best-kept secret, and we need to be creative in how we identify and enroll eligible children into the program.”

Finally, the bill would make various reforms in the individual and small employer insurance markets to ensure affordability and stabilize cost. The bill would require small business insurers to make a good faith effort to market individual policies, ensuring greater competition, establish modified community rating to make health care coverage more affordable for young professionals who have historically forgone health insurance due to the high cost, and modify the minimum loss ratio to ensure that a greater percentage of health care premium dollars is dedicated to direct health care costs, and not insurance administration.

“While we boost FamilyCare to provide health care access to the uninsured working poor, we need to do something for those people who have insurance, but are barely able to hang on,” said Vitale. “The cost of health care in this state is astronomical, and while many small employers are trying to do the right thing and provide health care coverage for their employees, many just can’t afford it. Public health care programs are only one part of the puzzle, and if we’re really going to achieve affordable health care in the Garden State, we need to make sure that private health insurance is within reach for those who don’t qualify for public assistance.

“Quality health care is not a privilege for the extremely wealthy, but a basic right for all people at all income levels,” added Vitale. “This isn’t a crisis where we can wait for federal relief, and we don’t know what form that relief might be in. We have to act now to protect the more than one million people around the state who are one major injury or illness away from bankruptcy and we have to do a better job in meeting our state’s obligation to the uninsured.”

The bill now heads to the Senate Budget and Appropriations Committee for review, before going to the full Senate for consideration.


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