To Christie, Medicaid Expansion Veto Keeps Options Open

Andrew Kitchenman | July 1, 2013 | Health Care
Governor says he wants to be able to move quickly if Obama administration reneges on any of its promises

Gov. Chris Christie is planning to expand Medicaid eligibility for low-income New Jersey residents, but he doesn’t want the expansion to be backed up by state law.

On Friday, Christie vetoed a bill (S-2644/A-4233) that would have made the expansion he announced in February permanent.

While he didn’t spell out why he vetoed the bill, he said when originally announcing the expansion that if the fiscal and public health benefits ever change “because of adverse actions by the Obama administration, I will end it as quickly as it started.”

Christie also vetoed bills that would have:

  • restored funding for family planning clinics — S-2825/A-4172;
  • expanded Medicaid family-planning funding for single residents — A-4171/S-2824;
  • and funded a public awareness campaign for the federally operated health insurance exchange — A-3878/S-2673.
  • While the Medicaid expansion veto may initially appear to be inconsistent with Christie’s support for the expansion itself, it was foreshadowed by concerns raised by Republicans during committee hearings on the bill.

    During those hearings, Republican legislators said Christie administration officials had told them that they were concerned that the bill would prevent the state from reversing course on the expansion if the federal government doesn’t live up to its obligations.

    The expansion is set to provide Medicaid to residents with incomes between roughly 26 percent and 138 percent of the federal poverty line, which currently amounts to single residents with incomes between $2,987 and $15,856, and couples with incomes between $4,033 and $21,430.

    Under the 2010 Affordable Care Act, the federal government is committed to paying 100 percent of the cost of the expansion through 2016, with the state share rising to 10 percent of the cost by 2020.

    Christie’s veto was immediately praised by Mike Proto of Americans for Prosperity, a group that opposed the ACA. Proto suggested that the veto would prevent the expansion, but Christie administration officials have indicated that the expansion will move forward without the legislation.

    “This is a win for the taxpayers of the state of New Jersey,” Proto said in a statement. “As AFP has stated time and again, this expansion would have put even greater pressure on an already strapped state budget, and forced more Americans onto a broken healthcare program.

    “Americans for Prosperity would like to thank all of those in the Assembly and Senate who realized that Medicaid is bad medicine and voted no on its original passage and once again thanks Gov. Christie for doing the right thing,” the statement added.

    Rather than issuing individual messages explaining why he vetoed each bill, Christie released an “omnibus” veto message for all four health-related bills, as well as bills that would have set standards for public service privatization contracts; required employers to provide public notice when relocating call-centers overseas; and prohibited state pension investments in companies making, importing, and selling assault firearms for civilian use. Also included is a bill providing state aid for property tax relief to towns that lose major businesses.

    “Accompanying the budget, but not part of the negotiated appropriation, were proposals that would deplete the state’s fiscal resources, restructure government in a significant manner, and significantly alter the policy and spending priorities set forth in the Appropriations Act,” Christie wrote.

    The bill restoring funding to family-planning clinics would have cost $7.45 million, while the Medicaid family-planning expansion would have cost roughly $1.1 million, based on an earlier administration estimate.

    It’s not clear how much the public awareness campaign for the federal health insurance exchange would have cost. Officials with the nonpartisan Office of Legislative Services wrote a fiscal estimate that indicated the cost would have varied widely depending on what the Department of Banking and Insurance did if the bill became law.

    The federal government is planning to advertise the marketplace, which is scheduled to begin enrolling residents on October 1 for insurance that would start on January 1, 2014. The state could have done as little as join the federal public awareness campaign or it could have conducted its own potentially expensive campaign, according to the OLS fiscal estimate.