With the threat of massive federal reforms that could reduce healthcare coverage nationwide — and rising public frustration over that possibility — Democratic gubernatorial hopefuls are showing a growing interest in single-payer coverage as a way to protect New Jersey patients.
State Assemblyman John Wisniewski, a Sayreville attorney, was an early supporter of a single-payer model that he said would be available to all Garden State residents at lower costs then they now pay. On Tuesday Montclair lawyer Jim Johnson, a former U.S. Treasury official, outlined a five-point “Trump Protection Plan” that also called for a “Medicare-for-all” model.
State Sen. Ray Lesniak of Elizabeth, a longtime lawmaker who has championed efforts to protect vulnerable residents, agreed last week, noting that universal healthcare could be funded by closing loopholes and ending tax breaks for the wealthiest residents. And frontrunner Phil Murphy, a retired Goldman Sachs executive who lives in Middletown, agreed it is imperative to protect widespread coverage for those that can’t afford care. Murphy has
supported a “Medicare-for-all” model on the federal level, but said he is also willing to explore a state-run public insurance plan.
Long shot no more?
Once considered a long-shot by healthcare experts, there has been renewed interest in single-payer plans — models in which all patients are covered by one, generally government-run insurance system — in recent months, as federal officials debate the future of the Affordable Care Act. Several states are now exploring such plans, including New York, Massachusetts, and California. (Vermont approved a program in 2011, but it was never implemented.)
“It’s like others around the world look at our healthcare debates and scratch their heads and wonder how do you leave people off” the insurance rolls, Murphy said during last Thursday’s Democratic primary debate, co-hosted by NJ Spotlight and NJTV News. He said that universal coverage for New Jersey residents “has to be considered, but it’s a ton of money. But we have to do what it takes.”
Researchers have predicted that the GOP proposal to replace the ACA, or Obamacare, would eliminate at least a half million New Jersey residents from the health insurance rolls and would drive up costs for tens of thousands more, especially older or less-healthy individuals. The bill, which narrowly passed the U.S. House of Representatives in early May — with support from two out of the Garden State’s five Republican congressmen — is now pending in the U.S. Senate, where lawmakers from both parties have pledged to make changes.
Protecting Planned Parenthood
All four candidates competing for the Democratic gubernatorial nomination in the June 6 primary have also called for protecting or restoring funding for Planned Parenthood and other women’s healthcare facilities. The GOP proposal calls for defunding Planned Parenthood by blocking its ability to charge Medicaid for cancer screenings, wellness visits, and other treatments provided to low-income patients on the government plan.
A Quinnipiac University poll released earlier this month showed that most voters were undecided. Murphy got 26 percent of the primary vote, with 7 percent for Johnson, 5 percent for Wisniewski and 4 percent for Lesniak. Two other candidates who did not raise enough money to be included in the formal debates are activist Bill Brennan, a firefighter who sued Christie over the Bridgegate scandal, who got 3 percent, and Tenafly councilman Mark Zinna, who received 1 percent.
These numbers seemed to change with polling from last week’s debate, although Murphy continued to hold the lead. Instant and daily polls are not considered all that accurate, since they take into account only those voters who are closely paying attention.
Wisniewski’s healthcare plan
Wisniewski, the longtime head of the Assembly transportation committee, has laid out the most detailed healthcare plan yet with his call for a single-payer system. According to his website, the plan would be available to all New Jersey residents, regardless of what they earn or which doctors they want to visit; it would cover all the “essential benefits” now provided by Obamacare, including maternity care, mental health, and substance abuse treatment — some of which could be eliminated under the GOP proposal.
People would pay lower premiums than they do with employer-based plans, he claims, and this money would funnel into a state-run system that would reimburse the providers, according to Wisniewski’s site. Additional money would come from Medicaid and other federal dollars, existing state healthcare funding, and savings generated through discounted rates the state would negotiate for prescription benefits. In fact, the assemblyman said the plan could generate as much as $7 billion in savings — enough to cover the new costs it creates.
“It’s long past time we made healthcare a fundamental right in this state,” Wisniewski said during Thursday’s debate, noting that many of the state’s public health issues — like the addiction crisis — can be tied to a lack of healthcare investment. “One of the root causes is a lack of quality healthcare and the access to that healthcare. A single-payer plan would be able to [help address] that,” he said.
Trump Protection Plan
On Tuesday Johnson outlined some of his healthcare goals in introducing his Trump Protection Plan at a press conference in Bedminster. The proposal — which also calls for greater protection for immigrants, the middle class, the environment and justice in general — said a single-payer “Medicare-for-all” plan would be appropriate if the ACA is gutted by Republican reforms. It also reiterates the need to support women’s healthcare services, but offers no details on the proposals.
In addition, Johnson has outlined an approach to reducing the cost of prescription drugs that would involve far greater transparency among pharmaceutical manufacturers and more aggressive investigations into potential price gouging or anti-trust actions among these companies. His plan builds on an ACA effort to hold down insurance costs by requiring drug makers to justify price hikes in advance and reveal what they spend on marketing.
Johnson has called the GOP effort to repeal Obamacare “cruel and offensive” and pledged to uphold coverage for those with pre-existing conditions. But during the Democratic debate last week, he also reminded his colleagues that such bold plans cost money. “We have to agree that healthcare is essential, but also we need to make sure that all of our math works,” Johnson said. “I am committed to making sure everyone has coverage, but have to make hard choices.”
Lesniak and addiction recovery
Lesniak, a longtime advocate for addiction recovery programs, proposed a measure last fall that would ban insurance companies from paying for opiates if the prescribing doctor did not thoroughly investigate the patient’s medical history, comply with guidelines that limit the number of pills dispensed, and inform the patient of all the risks involved with addictive painkillers.
When asked during the debate about his support for a single-payer plan, Lesniak agreed a universal healthcare system made sense — especially given the uncertainty in Washington, D.C. He suggested a solution was “so simple” and said potential healthcare gaps caused by the repeal of the ACA — estimated to cost New Jersey much as $4 billion a year — could be filled by tapping wealthy residents for more revenue, either through eliminating tax cuts or plugging Internal Revenue Service loopholes.
“If [Republicans are] going to take it away and give it to the wealthy, we’ll take it from the wealthy and give it back to the people,” he said.
Murphy, who has locked up support from the Democratic organizations in all 21 counties, has prioritized protecting ACA coverage now in place. In April he was endorsed by U.S. Rep. Bill Pascrell, a Passaic Democrat, who called him “the right partner” to help push back on the GOP agenda championed by President Donald Trump.
In addition, Murphy has stressed the need to reduce insurance premiums for commercial plans by addressing excessive out-of-network provider charges, an issue that has long dogged Garden State residents. He has called for ensuring New Jersey women have access to contraception at no out-of-pocket cost, expanding access to addiction treatment, and finding a way to enroll the state’s remaining 75,000 uninsured children in a healthcare plan.
“If it comes to it, we have to have all options on the table, and it will be expensive,” Murphy warned during Thursday’s debate.