Booker and Menendez Explain How NJ Is Resisting Federal Healthcare Policies

Lilo H. Stainton | August 7, 2018 | Health Care
Senators and state Health Commissioner outline efforts to stop Trump administration from dismantling ACA and impeding other initiatives

U.S. Sens. Cory Booker, left, and Bob Menendez praised Gov. Phil Murphy for protecting coverage under ACA.
New Jersey leaders are working at both the state and national levels to push back against any dismantling — or blocking — of healthcare programs in Washington D.C.

U.S. Sens. Cory Booker and Robert Menendez (both D-NJ) and state Department of Health Commissioner Dr. Shereef Elnahal shared that message during a forum on healthcare at Capital Health Medical Center in Hopewell that addressed changes to the Affordable Care Act, reforms to the state’s medical marijuana program, a new effort to reduce opioid use, and other topics.

The event was organized by Booker’s office and NJ Spotlight, moderated by the author, and attended by more than 100 staff and supporters of Capital Health and NJ Spotlight members, who met privately with Booker before the hour-long forum.

Some of these efforts are already paying off for Garden State residents, the officials said, noting that the rising price of insurance policies has slowed, more patients are able to obtain medical cannabis for their ailments, and the state is launching a program to further reduce opioid prescription use in emergency departments, a common source for addictive prescriptions.

Department of Health Commissioner Dr. Shereef Elnahal
When it comes to the ACA, Gov. Phil Murphy, a Democrat, has signed several laws that will help stabilize the individual health insurance market in the wake of changes implemented by the Trump administration. As a result, it’s estimated that premiums for the coming year will rise less than 6 percent, Elnahal said, compared to the more than 20 percent hike many policyholders faced this year.

“It could have been the same” this year, Elnahal said, without these interventions. In addition to creating a state mandate for insurance coverage, with a tax penalty for those who lack coverage — a mechanism designed to encourage healthy people to purchase policies and better spread the cost of risk, which Trump eliminated as part of a tax reform last year — Murphy has ordered the state to set up a healthcare reinsurance pool to help offset the burden of the most costly claims.

Medical marijuana

New Jersey has also significantly expanded access to medicinal marijuana under Murphy, adding more qualifying conditions or diseases and better publicizing the program to draw close to 1,000 new patients a month. “And we expect to double the size of the program by the end of the calendar year,” Elnahal said, to covering more than 30,000 residents. “But we need action at the federal level to support these actions.”

The trio also discussed an innovative program launched at St. Joseph’s Hospital, in Paterson, that has helped reduce by some 80 percent in two years the amount of opioids dispensed by the entity’s emergency room, the busiest in the state. Elnahal said the DOH wants to replicate this sort of result statewide and will invest a portion of the $100 million Murphy set aside in March to tackle the opioid epidemic in an effort to do so, in partnership with the New Jersey Hospital Association, which represents the state’s 71 acute-care facilities.

After the event, Elnahal said the DOH is working to create a charter with the NJHA to guide the program’s implementation. He envisions a system in which each facility would receive a designation — gold, silver or bronze — based on its efforts to reduce opioid prescription use in its emergency department.

Sens. Booker and Menendez (second and third from right) have strongly supported the Alternatives to Opioids (ALTO) program at St. Joseph's Hospital, Paterson.
Menendez, a senior member of the congressional committee that oversees healthcare policy, and Booker, a vocal advocate for wider insurance coverage, were early champions of the St. Joseph’s program, the Alternatives to Opioids, or ALTO. Along with U.S. Rep. Bill Pascrell (D-NJ), they have sponsored a federal bill to create a three-year national pilot program based on the ALTO model.

Booker has also introduced legislation to expand access to medicinal marijuana nationwide, including a bill that would remove cannabis from the federal list of controlled substances, a status that makes it hard to conduct clinical studies on the medicine’s impact. Menendez, who sits on the banking commission, has sought to change laws that prohibit the use of banks or other financing for medicinal marijuana programs.

Booker: Democratic Party will defend ACA

“We clearly need the federal government to stand down and allow the states to ultimately operate” medicinal marijuana programs, Booker said.

Defending the ACA, or Obamacare, in Washington, D.C. is also a priority for both senators, a process that continues today through policy modifications, legislative attacks and court challenges to the law. While Booker co-sponsored the Medicare For All proposal championed by former presidential candidate Sen. Bernie Sanders (I-VT), he told the audience at Capital Health that the “force and focus” of the Democratic party is defending the current law, which has helped some 800,000 Garden State residents obtain healthcare coverage since 2014.

Menendez noted that changes to the ACA under President Donald Trump have reduced funding for cost-sharing programs designed to help some working-class consumers afford healthcare premiums and, in New Jersey, this drove up costs significantly for nearly 140,000 residents who purchase insurance through the individual market. “That’s cost New Jersey $150 million dollars,” Menendez said.

Battle over pre-existing conditions

In addition, Menendez has weighed in on a legal battle in Texas that could change how healthcare policies cover individuals with pre-existing conditions, like asthma or depression, and end the ACA’s ban on lifetime insurance-benefit caps, among other elements of the law. The ACA prevented insurance companies from discriminating against patients who had previous diagnoses, but it is being challenged in a federal court and the Trump administration has declined to defend the law, a situation Menendez and Booker consider shocking.

Research from the Kaiser Family Foundation suggests some 3.6 million Garden State residents who would not otherwise have been able to obtain or afford coverage were able to qualify under this part of the ACA. “I didn’t realize how many New Jerseyans had a pre-existing condition,” Menendez said, noting it was now closer to 3.8 million. “When my staff gave me the number, I asked them to go back (and double-check) because the number is staggering.”