As Time Runs Out on $7.67 Million Grant, Health Advocates Step up Criticism

U.S. official says state could spend money marketing, the federal health insurance marketplace

State Sen. Nia H. Gill (D-Essex and Passaic) at NJ Spotlight Conference on Implementing the Affordable Care Act in New Jersey.
Today marks the state’s last chance to spend a $7.67 million federal grant — and the Christie administration may leave the money on the table, much to the dismay of healthcare advocates.

The grant was awarded by the Centers for Medicare and Medicaid Services (CMS) in February 2012 to help the state establish its own health insurance exchange.

But Gov. Chris Christie later decided to have the federal government operate New Jersey’s insurance marketplace. Since then, state and federal officials have been in talks about how the money should be spent.

Today is the deadline for the federal government to approve any state request for spending the money. State officials have not publicly disclosed how they would like to use the funds.

A coalition of groups advocating increased access to healthcare would like the money used to increase public awareness of the marketplace, which is one of the two major ways that the 2010 Affordable Care Act widens access to insurance coverage, along with the expansion of Medicaid eligibility.

The coalition’s position appears to be in line with potential uses for the money that were outlined by CMS Director Gary Cohen in a letter to state Sen. Nia H. Gill (D-Essex and Passaic).

Cohen wrote that states with federal marketplaces “may conduct statewide marketing activities to promote” them, as long as they follow federal guidelines.

Gill said too many New Jersey residents don’t know that they may be eligible to get subsidies to buy insurance through the marketplace. The subsidies are available for people with incomes between 100 percent and 400 percent of the federal poverty line, which is currently between $23,550 and $94,200 for a family of four.

“It is incomprehensible that the administration has failed to submit an acceptable plan to use this funding, and is now due to allow millions of dollars in vitally needed funds to expire,” Gill said in a statement.

New Jersey Citizen Action healthcare policy advocate Maura Collinsgru said the state should have submitted plans to use the money to advertise the marketplace last year.

Collinsgru questioned what the Christie administration has gained by not reaching an agreement with the federal government.

“Outreach and marketing of the marketplace is not rocket science,” Collinsgru said. “I don’t know that it takes eight months and reaching the 11th hour — to me there has to be something else at work here.”

The difficulty informing people about the health insurance marketplace has compounded problems that the website,, had throughout the fall, she said.

“We’ve had a lot of issues with people signing up — this is a barrier that does not need to be there,” Collinsgru said. “People in New Jersey need to make their own choice, to find out what their options are and then choose what they want to do.”

Collinsgru said a state-led grassroots advertising campaign — including everything from signs on public transit to posters at local businesses — could have reached more New Jersey residents.

A New Jersey Policy Perspective estimated in a recent report that up to 95,000 more residents would receive insurance if the state engaged in an intensive marketing and outreach effort.

U.S. Rep. Bill Pascrell (D-Paterson) said in a statement that Christie “has prided himself on being an impediment to providing healthcare to New Jerseyans instead of being a partner in implementing this law. It’s clear that obstruction is the name of the game for radical Republican governors across the country.”

Pascrell introduced federal legislation that would allow the federal government to redirect grants that state governments choose not to spend and give the money to organizations to engage in marketplace outreach, education, and enrollment.

Christie was one of a minority of Republican governors who agreed to expand Medicaid eligibility. However, he decided not to operate a state exchange, citing the potential for costs to the state and a lack of answers from federal officials to questions posed by Christie and other Republican governors.

The leader of one of the five organizations named by the federal government as “navigators” and given federal funds to enroll residents in ACA insurance, joined in expressing concern about the looming deadline.

Elnora Watson, executive director of the Urban League of Hudson County, noted that many more state residents have been enrolling in the Medicaid expansion through New Jersey FamilyCare than in the marketplace.

“Medicaid involves state coordination and is on target to make projected goals. These funds intended to support marketplace enrollments went unspent,” Watson said in a statement released by Pascrell’s office. “As a result there are entire swaths of the state where uninsured, largely minority communities are hugely underserved. And those residents are suffering needlessly.”

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