This is the fourth story in an occasional series assessing and exploring where the leading candidates stand on the most important issues facing New Jersey. Follow this link to read all the articles in this series.
Despite the continuing national focus on the Affordable Care Act and other healthcare issues — and the role these played earlier in the campaign — taxes, immigration, and other topics have taken over center stage in New Jersey’s gubernatorial campaign.
Democrat Phil Murphy, a former Goldman Sachs executive and U.S. Ambassador to Germany, and Republican Kim Guadagno, the current lieutenant governor and a former Monmouth County sheriff, outlined their differences on a number of key issues in healthcare during their primary battles against other candidates earlier this year.
[img-narrow:/assets/17/1023/0027] But the big health-related issues that have sparked protests on Capitol Hill and at some congressional offices in the Garden State have now taken more of a back seat during recent debates and in public conversations this fall. (The election is Tuesday, November 7; details on the gubernatorial and local candidates, their issues and fundraising, polling place locations, and more can be found on the NJ Spotlight election page.)
Murphy details his plans for a handful of healthcare issues on his website, but provided only general statements in response to specific questions. Guadagno’s website outlines her proposals to address addiction, but her spokesman declined to respond to questions about this or other issues, despite an initial indication he would.
One issue Murphy highlights online — which also became a hot topic in the primary — is support for women’s healthcare. In New Jersey, this has come to mean that a candidate would restore an annual allocation of $7.5 million for community clinics (including Planned Parenthood facilities) that provide low-cost healthcare, including birth control, prenatal care, cancer screenings, and more.
Gov. Chris Christie eliminated this funding in 2010 and the issue has become a litmus test for many groups in the years since, with Democratic leaders pledging they would bring back the funding if they take control of the governor’s office.
Murphy has stressed he would restore this line item and ensure that all approved birth-control methods would be available free of charge.
Guadagno has been far less clear about her plans; she has said she supports women’s healthcare and is personally pro-choice, but opposes any public funding to pay for abortions — something federal law already prohibits.
Both candidates prioritize opioid crisis
Addressing opioid addiction, which Christie declared a public health crisis in January, is also a priority for both candidates.
While Guadagno has worked hard to distance herself from the governor, several of the specific goals she identifies — expanding the use of recovery coaches, improving access to treatment, reducing insurance barriers and diverting non-violent criminals to drug programs, for example — appear to build on Christie’s initiatives, which have gained professional respect.
Guadagno also wants to ensure addicts same-day access to detox facilities near their homes and to overhaul the state’s prescription drug database, which hasn’t been updated in years, to make the process of identifying abusers more efficient.
In addition, she calls for a regional coalition of state and local law enforcement, private sector, nonprofit leaders, and others who could find ways to better pool resources and share best practices. Her spokesman Ricky Diaz declined to offer specifics.
“Like many diseases, addiction can often be prevented. Employing an effective prevention strategy must be our goal because it is more effective and cheaper both in terms of heartbreak and cost than a thousand trips to rehab,” Gaudagno’s website reads.
Addiction ‘not a partisan issue’
Murphy also seeks to expand access to treatment services. His website frames investment in drug treatment as money well spent, noting that every $1 invested saves $10 over time. He embraces the use of medication-assisted treatment to help addicts avoid relapse and hopes to negotiate with the makers of naloxone, the powerful overdose reversal agent, to reduce the cost and make it easier for communities to provide it to first responders.
The Murphy website notes that he would limit initial opioid prescriptions to seven days, although Christie signed a law that imposed a five-day limit in February. When asked about this discrepancy, his spokesman Derek Roseman said Murphy had been “fully supportive of the Legislature’s work” to implement this change and would “ensure its enforcement.”
“Phil has been clear that addiction, especially with our opioid crisis, is not a partisan issue, it is a human one. We must maximize all available federal funding to match with available state funds to ensure fighting addiction is a state health priority,” Roseman said.
Murphy wants to protect ACA
The Democratic contender has also been clear about his interest in protecting the ACA, or Obamacare, which since 2014 has added some 800,000 to the health insurance rolls in New Jersey, expanded benefits for millions of others, and provided the state billions in additional federal dollars each year.
Murphy has vowed that he will be “leading the fight to push back against any efforts to repeal the coverage hundreds of thousands of New Jerseyans rely upon,” Roseman said.
Proposed Republican reform plans, which failed to gain sufficient traction in Congress, would have cut funding in ways that likely would have caused tens of millions of Americans to lose the coverage they gained under the ACA and cut billions from state budgets.
In fact, Murphy hopes to expand coverage to reach some 75,000 currently uninsured children who could be enrolled in existing state or federal programs, although Roseman declined to say how this would be done.
“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 last spring, during a Democratic primary debate, co-hosted by NJ Spotlight and NJTV News.
During the primary, which included several progressive Democrats, discussions of defending the ACA led to growing support for single-payer healthcare plans in which the government would replace the role of insurance companies. At the time, Murphy said he supported the concept of a “Medicare-for-all” plan at the federal level and would be willing to explore the idea for New Jersey.
But a portion of Murphy’s response to a debate question about a state single-payer plan — that it “has to be considered, but it’s a ton of money…” — was cut and pasted into a Guadagno ad that focused on Murphy’s plans to generate new revenue to address a variety of concerns. As a result, Murphy has frequently been forced to clarify his preference for a federally funded single-payer program.
Guadagno wants to fix ACA
Guadagno has also had to struggle with some nuances when it comes to the ACA, which she has said was a bad bet from the start. “I believe [Obamacare] was a bad business plan. It was slowly going broke,” she said this spring, during a debate at Stockton University.
“But there has to be a way to fix it so the people of New Jersey are not harmed,” Guadagno added, placing her in opposition to plans endorsed by President Donald Trump and Republican leaders in Washington, D.C.
At a healthcare forum held this summer at Rowan University, Guadagno noted that despite the ACA’s problems, destroying it would cause the “collapse” of a number of safety-net hospitals in New Jersey, facilities that have come to depend on the funding they get by treating new Medicaid patients enrolled through the program. She also said she supports protecting coverage for individuals with pre-existing conditions who might lose care under certain GOP-proposed reforms, ensuring physician choice, and actually reducing the cost of healthcare.
A single-payer system is one option Guadagno has made clear she opposes all along.
“The Lt. Governor opposes government-run health care because it will explode costs and limit care for New Jerseyans, especially for seniors who would no longer be able to pick their own doctors,” Diaz told NJ Spotlight in May.