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As the U.S. Senate continues working on the unpopular House bill to drastically change the Affordable Care Act, federal marketplace enrollment data provide a snapshot of New Jersey’s nearly 300,000 enrollees who would be affected by the revisions.
The federal Centers for Medicare and Medicaid Services recently releasedon the 2017 open enrollment period, running from November 1, 2016, through January 31, 2016, for the health insurance marketplaces. They show the largest concentrations of people buying insurance through the marketplace were in the Lakewood-Toms River area in Ocean County and in Union City, North Bergen, and West New York in Hudson County.
While the greatest change in the law would significantly restructure Medicaid funding, which could cost 500,000 New Jerseyans their coverage, there are also provisions in the American Health Care Act that passed the House earlier this month that would affect those buying insurance in the marketplace.
For instance, the bill would replace the current Obamacare subsidies with typically smaller tax credits of between $2,000 and $4,000. The CMS data show that current enrollees in more than 70 percent of the state’s ZIP codes were eligible for more than $4,000 in tax credits for insurance, with those in two — Lakehurst and Toms River getting more than $5,000. An analysis by the progressive think tank New Jersey Policy Perspective stated that some 250,000 New Jerseyans buying insurance through the marketplace would see an average increase in out-of-pocket costs of $2,740 a year, making insurance unaffordable for many.
And the provision that would allow insurance companies to charge more for pre-existing conditions could make coverage unaffordable to some. According to the Kaiser Family Foundation, 23 percent of New Jersey’s non-elderly adults, or 1.2 million people, had pre-existing conditions that made them essentially uninsurable in the days before the ACA took effect. NJPP found it would cost about $790 million a year to help those New Jerseyans with pre-existing conditions who would apply for health coverage, and the state could expect to get only $353 million from the federal government to help pay for that coverage, leaving a $437 million gap.
Statewide, according to the CMS data, more than two-thirds of New Jersey’s marketplace enrollees got either a cost-reduction or tax credit or both to help them get coverage. Overall, the average monthly premium was $479, but the average premium for those getting a tax credit would be just $148 a month.
Looking at demographics, the largest proportion of enrollees were white, female, and between 55 and 64, the years before becoming eligible for Medicare. According to income, the greatest concentration of those in the marketplace made between 150 percent and 200 percent of the federal poverty level, which is $20,160 for a family of three, too wealthy to qualify for Medicaid.
Not surprisingly, Bergen County, which has the greatest population of all the counties in New Jersey, had the largest number of enrollees — 38,349. Large proportions of enrollees were eligible for cost reductions or tax credits in every county, even the wealthiest. The percentage of enrollees getting tax credits ranged from 72 percent in Somerset County to nearly 85 percent in Atlantic.