Without Federal ACA Funds, Analysts Foresee Fewer Insurance Sign-Ups in NJ

Coalition keeps enrollment target, but counts on foundations and volunteers to make up for federal grants lost due to Christie administration’s stance

Marilyn Askin, AARP New Jersey’s chief advocate, said her organization’s members are benefiting from the expanded insurance availability through the Affordable Care Act.
More than 170,000 fewer New Jerseyans than previously projected will get health insurance through the Affordable Care Act, according to an estimate published by healthcare policy analysts after the state lost a federal grant that could have been used for outreach efforts.

The estimated number of new enrollees through New Jersey FamilyCare – the state’s Medicaid program – and the federal health insurance marketplace has dropped 31 percent, from 548,783 to 378,661 through the end of 2016, according to the report prepared by New Jersey Policy Perspective in cooperation with the Rutgers Center for State Health Policy.

However, the report’s lead author, Raymond J. Castro, and a coalition of healthcare advocates say the original estimate remains their goal, which they say might be reached with private foundation funding and volunteer efforts to make up for the lost federal funds.

“I think it’s good to have goals that are difficult to attain – that’s sort of why you have goals,” said Castro, New Jersey Policy Perspective’s senior policy analyst.

Members of the New Jersey for Health Care Coalition said the state lost two major opportunities for federal funding that would have made reaching the original goal easier.

Gov. Chris Christie’s decision to have a federal marketplace rather than a state-run exchange likely cost the state more than $20 million for outreach efforts, while the state recently lost a $7.67 million grant that federal officials said could have been used for marketing.

Christie cited uncertainty over costs the state might incur if it opted for a state-run exhchange, while Banking and Insurance Commissioner Kenneth Kobylowski wrote in a letter last month that federal officials rejected state plans for the grant and wouldn’t give the state enough flexibility. The Christie administration did not want to use the $7.67 million for marketing the program.

Coalition coordinator Maura Collinsgru, healthcare policy advocate for New Jersey Citizen Action, said the state squandered the grant money. She also reiterated at a press conference announcing the report that the coalition is committed to meeting the original goal.

“Whatever the number is at the end of March, this group of outreach enrollment agencies and workers, as well as our partners statewide, remain committed to furthering the ACA implementation and connecting New Jerseyans to coverage,” Collinsgru said.

The lower estimate results from what the report authors describe as “standard outreach,” rather than the “enhanced outreach” that would have been available with the federal funding.

Castro also remains hopeful that the state eventually will reach the original goal.

“It the state’s isn’t going to support us, we’re going to do everything we can to support ourselves,” Castro said.

In addition to the revised estimates – which are based on Congressional Budget Office and Urban Institute research – the report includes county-by-county goals for 2014, 2015 and 2016. The goals for newly insured residents range from a high of 66,217 in Essex County to a low of 3,825 in Warren County.

The report authors estimate that New Jersey FamilyCare will reach its goals sooner than the target enrollment is reached for the marketplace, noted Dorothy Gaboda. She is the associate director for data analysis for the Rutgers Center for Health Policy, which developed the original goals.

“They’re people who are already known to the state in one capacity or another,” and are more likely to be receiving healthcare from hospitals and clinics that can help them enroll, Gaboda said, referring to potential FamilyCare enrollees.

The most immediate goals included in the report are for the end of this month, which marks the end of the first open enrollment period for insurance purchased through the marketplace. The report foresees 113,322 enrollees through the marketplace and 71,580 through FamilyCare by March 31 if the state is able to reach the original goals. However, the revised estimate is for 78,192 marketplace enrollees and 49,390 FamilyCare enrollees.

The next open enrollment period is scheduled to begin on November 15, although people who lose their insurance coverage during the year will still be able to buy plans through the marketplace.

Castro said the monthly estimates that the report includes, as well as the annual goals, will be a useful benchmark that be drawn upon by coalition members and recipients of federal Navigator grants to enroll residents.

“We are in it for the long haul,” Castro said, adding that New Jersey Policy Perspective will be posting monthly updates on the state’s progress.

Representatives of two Navigator organizations – the Center for Family Services and the Urban League of Hudson County – joined with counterparts from nine other coalition groups in announcing their support for the monthly goals.

Marilyn Askin, AARP New Jersey’s chief advocate, said her organization’s members are benefiting from the insurance expansion.

“One of the beauties of the ACA is that it gives workers new mobility,” said Askin, adding: “We are constantly reminded by our members that they are just a pink slip away from being uninsured.”

Young people also are benefiting, said Jen Kim, state director for New Jersey Public Interest Research Group’s law and policy center.

“With the new health insurance marketplace, it’s getting easier to compare plans and find coverage that fits into people’s budgets and keeps them healthy,” Kim said.