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Monthly Enrollment Surge Continues for New Jersey FamilyCare

More than 45,000 gain insurance coverage through expanded Medicaid as counties, state work through backlog of applications

Joel C. Cantor
Credit: Amanda Brown
Joel Cantor, director of the Rutgers Center for State Health Policy.

May was another strong month for enrollment in New Jersey FamilyCare, as the effects of expanding Medicaid eligibility under the Affordable Care Act continue to be evident in the state.

A monthly enrollment report showed that 1,485,576 state residents were covered by FamilyCare, which includes coverage through Medicaid and the Children’s Health Insurance Program. That total represented a 45,674-person increase from April and a 201,095-person increase since January 1, when the eligibility expansion went into effect.

The numbers suggest that the number of uninsured New Jerseyans has continued to fall since early March, when a Robert Wood Johnson Foundation-sponsored survey found that the percentage of state residents without insurance had already fallen to 13.2 percent, down from 21.2 percent in September.

The May enrollment gains were greatest among adults without children, the primary beneficiaries of the eligibility expansion, which was -- along with the federal health insurance marketplace -- one of the primary ways the Affordable Care Act expanded coverage.

It’s not clear how many of the new enrollees applied in May, and how many had applied in previous months but were waiting to be enrolled as county welfare offices and the state Medicaid application contractor continued to work through a backlog of applications.

Overwhelmed county welfare offices and outdated technology have contributed to that backlog. While a statewide figure isn’t available, a national survey estimated a nationwide backlog of 2.9 million applicants.

The 201,000-gain in FamilyCare enrollments is closing in on the 234,000 Medicaid enrollee gain projected by the Rutgers Center for State Health Policy in 2011, but center director Joel Cantor said it is too early to say whether the state will exceed the projection.

“We did expect that the largest share of enrollment to come in fairly quickly although we’re ahead of where we originally thought we’d be by now,” said Cantor, who is an NJ Spotlight columnist. “And so we may end up exceeding our projection, but that would be speculation at this point.”

The enrollment increase has translated into an increase in people receiving healthcare, according to Eva Turbiner, CEO of Zufall Health Center, a federally qualified health center that serves Hunterdon, Morris, Somerset and Warren counties.

“We are certainly seeing more Medicaid” patients, Turbiner said, adding that the center has also seen even more people who bought insurance through the ACA marketplace.

“This doesn’t surprise us – in these counties, there were a lot of what we call the working poor,” Turbiner added. “They were desperately hoping that they could get onto the Medicaid program, so it’s clear that they have.”

For example, the number of Morris County adults who aren’t aged, blind or disabled who receive FamilyCare or Medicaid coverage increased from 5,312 in December to 11,041 in May.

Zufall has been expanding the number of centers it operates, as well as its hours, thanks in part to funding through the ACA. It has added sites in Hackettstown and Somerville and a dental center in Flemington.

“Frankly, the demand is there, we are not sitting empty for sure,” Turbiner said. “We are quite busy and people are anxious to get services.”

Turbiner said the numbers reinforce the importance of the Medicaid expansion, which Gov. Chris Christie agreed to. The federal government is covering 100 percent of the costs of the newly eligible population through 2016, after which the state’s share of the cost will slowly rise, to 10 percent in 2020.

Some people had delayed seeking needed medical care because they didn’t have coverage.

“I think it’s really necessary for the health of New Jersey residents,” Turbiner said. “These are folks who were on the charity care rolls previously, who are now being funded by 100 percent federal Medicaid dollars.”

Turbiner added that there is still a shortage of medical specialists who accept FamilyCare patients as part of a Medicaid managed care organization network, including orthopedists and urologists. Zufall staff members work to locate nearby specialists -- and when none are available, work with insurers to pay for out-of-network doctors.

Raymond J. Castro, senior policy analyst for New Jersey Policy Perspective, noted that the total FamilyCare enrollment gains were well ahead of schedule. The monthly projections calculated by Castro and the Rutgers Center for State Health Policy didn’t expect the state to reach 201,000 new enrollees until October 2015.

Both Castro and Maura Collinsgru, healthcare policy advocate for New Jersey Citizen Action, said the monthly gain reflects the amount of outreach and education that’s successfully reached state residents.

“For us, it was a real good indicator that the momentum does continue” after the end of the open enrollment period for the marketplace, said Collinsgru, who coordinates the work of New Jersey for Health Care, a statewide coalition of nonprofit and community organizations.

Collinsgru remains concerned that too many New Jersey residents are caught in the enrollment backlog. State officials have advised people who applied for FamilyCare to take the letter they received when they applied to a provider, and has urged providers to accept this documentation.

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