Gov. Chris Christie’s approach to healthcare reform is being criticized by one of the original authors of the 2010 Affordable Care Act.
U.S. Rep. Frank Pallone (D-Middlesex, Monmouth, Somerset and Union), who was a principal author of the law while serving as the chairman of the U.S. House Energy and Commerce Committee’s health subcommittee, called on Christie to support a state-run health-benefit exchange as well as expanded Medicaid eligibility, two major features of the ACA that Christie has thus far not expressed a willingness to do.
Pallone made his remarks at a press conference yesterday in which he endorsed state Sen. Barbara Buono (D-Middlesex) for governor.
“I’m very disappointed with the fact that Gov. Christie has refused to set up the exchanges,” Pallone said. “You know, he’s been very much backward on the issue of women’s health and whether or not we’re going to expand Medicaid.”
Christie’s stance on healthcare should be a major issue in the upcoming gubernatorial campaign because “Barbara has been very much out front.”
Health-benefit exchanges and Medicaid eligibility expansion are two of the key provisions for expanding health coverage under the ACA.
Christie vetoed a Democratic-sponsored bill that would have established a state-run health-benefit exchange, which would serve as an online marketplace for individuals and small businesses to buy insurance. It would also provide information on eligibility for subsidies.
Christie political adviser Michael DuHaime said the exchanges will be available to New Jerseyans, noting that the ACA allows states to have the federal government operate the exchanges as one of three options.
“I feel the insinuation that somehow the law will not be implemented is misleading at best – it will be implemented,” DuHaime said.
The governor has said that the federal government hasn’t given the state enough information about the costs of operating an exchange. He has until February 15 to decide whether to enter into a partnership exchange with the federal government or to have the federal government operate the exchange on its own.
As for Medicaid eligibility expansion, Christie has made few public comments. After the U.S. Supreme Court ruled last summer that states could decide whether to expand Medicaid, Christie said on Fox News that there isn’t much more the state could do after previous governors had already expanded the program.
On both the exchange and Medicaid expansion, Christie has joined with other Republican governors in asking for more information about how much the programs will cost the state, particularly if the federal government doesn’t cover the costs.
Under the Medicaid expansion, the maximum income for a single adult to be eligible for the program in New Jersey would rise from less than $3,000 to 138 percent of the federal poverty line, which currently amounts to $15,415 for a single adult. The federal government has committed to picking up 100 percent of the cost of the expansion from 2014 to 2016, with the federal commitment then dropping gradually, to 90 percent by 2020.
“For the people that are uninsured, it’s through Medicaid expansion that we insure, maybe, 15 million more Americans,” Pallone said. “And it’s with the exchanges that we not only provide the tax credits and subsidies so that more people can get insured, but also affordable insurance for people who already have insurance.”
Pallone described both decisions as “key factors” in providing insurance to the uninsured and affordable care to everyone.
Christie “seems to have suggested that he’s not going to do a state exchange, which I think is a mistake, because I think if the exchange is tailored to state than it’s better than if it was a federal exchange,” Pallone said.
The congressman said the federal match makes Medicaid expansion a good deal, even when the state will eventually begin paying 10 percent of the cost for the expanded population.
“We need to take advantage of it. First of all, it’s a 100-percent match, and then even at 90 percent, it doesn’t require a significant state match, so there’s really no reason not to take advantage of it,” Pallone said.
While healthcare advocates have largely supported Medicaid expansion, some employer groups, including the New Jersey Business & Industry Association, have met the proposal with skepticism. They have said that the federal government may not uphold its commitment, leaving the state to cover a funding gap.
Buono joined Pallone in criticizing Christie’s healthcare positions. She called his July comment that there is little for the state to do to expand Medicaid “factually incorrect.”
“It doesn’t make any sense from a fiscal perspective, as well as a human perspective,” she said.
Buono also said Christie has been delaying a decision on the state’s role in the exchange. She said a bill Christie vetoed would have provided necessary consumer protections.
“First, with the healthcare exchange, he wanted to see what the court said, then he wanted to see if Romney won, now it’s that he’s not getting enough information,” she said, accusing Christie of “dodging the issue.”
The federal government has not set a deadline for states to implement the Medicaid expansion, although federal officials have expressed hope that all states will ultimately choose to expand eligibility.