The number of uninsured New Jersey residents has been nearly cut in half, in large part due to the Affordable Care Act, according to a newly released survey.
The percentage of uninsured residents dropped from 21.2 percent in September 2013 to 11.5 percent in June 2014, according to the Health Reform Monitoring Survey, which is being conducted by the Urban Institute and funded by the Robert Wood Johnson Foundation, Ford Foundation and Urban Institute.
The updated numbers released Friday reflect a continuing decline in the ranks of the insured since the last survey, which was done in March and showed that 13.2 percent of New Jerseyans were uninsured.
While consistent with early reports, the latest survey is the first to indicate that the state has already seen such a large increase in insured residents – about 520,000 more people with coverage — due to a combination of factors, including people buying insurance on the federally operated individual marketplace and the expansion of Medicaid eligibility.
Despite the early software problems that delayed enrollment through the marketplace website, healthcare.gov, and backlogs in county welfare offices in processing Medicaid applications, the number of newly insured in the first year of the law appears to exceed projections by policy experts.
“Obviously there were a lot of administrative mishaps and so on in the Affordable Care Act, but its principal goal was to reduce the number of uninsured,” said Raymond J. Castro, senior policy analyst for New Jersey Policy Perspective. “That’s being achieved.”
The big improvement in the numbers between March and June was due, in part, to the last-minute flourish of enrollees in the federal insurance marketplace at the end of the open enrollment period, which originally was set to end on March 31 but was extended to April 19 to accommodate those who started but had not completed their applications before the deadline.
A total of 161,775 people enrolled through the marketplace through April. Federal officials haven’t updated state-by-state numbers since then, but said last week that 7.3 million people had paid premiums through mid-August, compared with the 8 million who had enrolled through April.
The next open enrollment period for the marketplace starts on Nov. 15. People with incomes between 100 percent and 400 percent of the poverty line are eligible for federal income tax credits to offset their insurance. That income cutoff currently amounts to between $11,670 and $46,680 for a single person and between $23,850 and $95,400 for a family of four.
The enrollment gains have also been aided by continuous growth throughout the year in the number of residents covered by New Jersey FamilyCare, which includes people covered by Medicaid and the Children’s Health Insurance Program (CHIP). FamilyCare added more than 151,000 to its rolls between March and June.
FamilyCare has continued to grow since then, indicating that future surveys could show even larger increases in the number of New Jerseyans who are insured.
Through August, FamilyCare covered 1,613,816 people, an increase of 329,335 since December, before the Jan. 1 expansion of eligibility. After the expansion, Medicaid now covers people with an income up to 138 percent of the poverty line, currently amounting to $16,105 for a single person and $32,913 for a family of four.
The FamilyCare increase includes roughly 281,000 adults and 48,000 children. While children were already eligible for CHIP, the widespread attention to the Medicaid expansion may have helped add more children to number of insured.
“One of the reasons we are getting much higher enrollment that we thought is that the number of people who are uninsured are applying in much higher numbers than we though they were,” Castro said.
The marketplace and Medicaid expansion were the two primary ways that the ACA expanded coverage. Gov. Chris Christie declined to establish a state-based insurance exchange, instead opting for the federal marketplace. However, he did choose to expand Medicaid eligibility, unlike most of his fellow Republican governors.
Castro said county welfare offices still have work to do to eliminate the backlog of Medicaid applicants.
But Castro said the enrollment gains reflected in the survey were highly encouraging. He noted that the ACA’s benefits extend beyond the raw number of newly insured residents.
“There is that impression that the ACA only affects people who are uninsured – all of us are guaranteed free preventive care,” and receive other benefits, Castro said.
Castro said the remaining 11.5 percent of New Jersey adults who are uninsured will be a challenge to insure, but he’s hopeful that there will be significant gains in the fall-winter open enrollment period.
“Those people who were most motivated are the ones who have applied” already, Castro said, adding that it’s going to require a much more targeted effort to reach the remaining people who are uninsured.
Castro said it will be difficult to reach this population with the limited funding available to the organizations that are helping people enroll.
But he added that they have learned from the last open enrollment which strategies were most effective. He said it sometimes takes three or four contacts with someone before they decide to apply.
“I think we can be more efficient this time around,” he said.
Disclaimer: The Robert Wood Johnson Foundation provides funding for NJ Spotlight’s health coverage.