In the middle of a global health crisis, New Jersey’s decision to take greater control of its marketplace for individual health insurance may already be paying off.
Gov. Phil Murphy announced Monday that more people have signed up for 2021 policies so far than had by this point last year, and many are slated to pay less in monthly premiums than they did in 2020. Some 269,500 health plans have been sold since the system, Get Covered New Jersey, opened on Nov. 1 — over 9% more than last year — and the average monthly cost for those receiving government help, which most do, was $121, Murphy said.
While the initial enrollment period closed at the end of January, Murphy recently announced that due to the coronavirus pandemic, state officials would keep the marketplace open until May 15 to give people more time to sign up. The governor said the change was important during the pandemic, since so many people have lost their jobs; at least 75,000 of those who have enrolled this season are new to the marketplace, he noted.
The state’s version of Obamacare, New Jersey’s marketplace policies are designed for people who do not have health coverage through work and are too well off to qualify for Medicaid. All the policies sold must cover essential health benefits including pregnancy, maternal and newborn care, mental health and substance abuse treatment, emergency visits and hospital stays, most doctors’ visits and prescription drugs among other services.
Greater flexibility, lower premiums
The 3 1/2-month extension would not have been possible in the past, when the marketplace — or insurance exchange, created as part of the national Affordable Care Act (ACA) — was controlled by the federal government. But Murphy said when he signed legislation in 2019 putting the state in charge of its insurance exchange that the switch would allow for greater flexibility, better outreach to potential customers and lower-cost products.
“We are incredibly pleased to see more residents obtaining health coverage through our new state-based marketplace during this critical time period,” Murphy said in a statement. He also congratulated state Department of Banking and Insurance Commissioner Marlene Caride and her team and Shabnam Salih, director of the Office of Healthcare Accountability and Transparency, an inter-agency policy initiative based in the governor’s office, for their work to create the state’s first marketplace.
By creating what the state calls the COVID-19 special enrollment period to extend marketplace sales until May 15, the state will enable people who don’t have coverage to purchase policies that could begin the following month. “We are keeping open the enrollment window to give those who still need health insurance the opportunity to get covered now, rather than having to wait until next year to enroll in a plan,” Caride said in a statement issued late Monday.
Shoring up the Affordable Care Act
Murphy has advanced various policies designed to shore up the Affordable Care Act, including creating a state-level insurance mandate — or tax penalty for those without coverage — after former President Donald Trump eliminated the federal requirement as part of a tax overhaul in 2017. Observers suggest this and other reforms, like the creation of a state-based reinsurance system to offset the impact of costly claims, resulted in a 9% decline in marketplace premiums in 2019 and minimal increases since then.
Last year, Murphy instituted a state-based tax on insurance premiums — essentially replacing a federal levy that Trump suspended — designed to generate at least $200 million annually to help marketplace customers afford their policies and provide additional funding for public outreach around Get Covered.
Subsidies are available for those who earn up to 400% of the federal poverty level — $51,040 for an individual or $86,880 for a family of three — and eight in 10 marketplace consumers qualify, according to the state. Murphy said these consumers will pay, on average, $43 less each month than they did in 2020 and $27 less than they did in 2014, the year the ACA marketplaces opened.