Affordable Care Act
NJ Spotlight compiles the most important ACA news and information. Please submit your news briefs to make sure they're featured.
- Rep. Frank Pallone to be guest speaker at ACA forum in Monmouth
"What Coverage Under the Affordable Care Act Means to You" will be the topic and Congressman Frank Pallone will be the guest speaker at a forum Monday, March 10, at Gregory Elementary School, 201 Monmouth Ave., Long Branch.
Those attending the free event, which will be held from 6 p.m. to 8:30 p.m., will learn about their coverage options under the ACA and get the chance to enroll in various healthcare programs.
The event is sponsored by Barnabas Health, Monmouth Medical Center, the Long Branch school system, Centers for Medicare & Medicaid Services, NJ Citizen Action, Food Bank of Ocean and Monmouth County, Monmouth Family Health Center and Visiting Nurse Association of Central Jersey.
- Somerset County library branches host ACA info, enrollment sessions
As the March 31 deadline approaches for the first round of health insurance signups under the Affordable Care Act, libraries in the Somerset County system are hosting free information and enrollment sessions.
Times, dates and branch location information is as follows:
Bound Brook Library, Thursdays, 3:30 p.m. to 8 p.m.
Bridgewater Library, Tuesdays, 3 p.m. to 8 p.m.; Wednesdays, 3:30 p.m. to 8 p.m.; Saturdays, 10 a.m. to 4 p.m.
Hillsborough Library, Saturdays, 1 p.m. to 4 p.m.
Manville Library, Mondays, 3:30 p.m. to 8 p.m.
Mary Jacobs Library, Rocky Hill, Thursdays, 3:30 p.m. to 8 p.m.
North Plainfield Library, Saturdays, 10:30 a.m. to 4 p.m.
Peapack Gladstone Library, third Wednesday of the month, 5:30 p.m. to 8:30 p.m.
Somerville Library, March 11, 11 a.m. to 8 p.m.
Warren Library, March 11, 4 p.m. to 8 p.m.
The enrollment assistance programs are being offered for free to all Somerset County residents.
Information that applicants will need to enroll includes: current healthcare insurance (if applicable) and policy numbers; information about healthcare coverage available through current jobs; Social Security numbers (or documentation for legal immigrants); household income; employer and income information verification for every member of household requiring coverage (pay stubs or W-2 forms are acceptable).
- Enroll America offers ACA signup assistance to Trenton residents
Information and signup sessions for Trenton residents interested in obtaining health insurance through the Affordable Care Act are being hosted in conjunction with community groups by the nonprofit and nonpartisan organization Enroll America.
Representatives of the group are on hand Friday mornings from 11 a.m. to 1 p.m. at the Trenton Rescue Mission. They also will be available to help residents apply for the healthcare coverage on Saturday, March 15, from 9 a.m. to 3 p.m., at Mount Bethel Church of God on Bellevue Avenue.
- Report: Most Uninsured Latinos Qualify for Lower-Cost Coverage
Nearly 80 percent of uninsured Latinos may qualify for Medicaid, CHIP (Children's Health Insurance Program) or lower-cost coverage through the health insurance marketplace, according to the federal Department of Health and Human Services.
The agency added that 95 percent of those same people might be able to get coverage if all states had agreed to expand Medicaid coverage under the Affordable Care Act.
According to a recent report by HHS, 1 in 4 uninsured individuals who are eligible for insurance through the insurance marketplace are Latino, amounting to 10.2 million out of 41.3 million people. More than 60 percent live in one of three states -- California, Texas and Florida -- and about half of them are 18 to 35 years old. More than 4 million Latinos may be eligible for CHIP or Medicaid and just under 4 million may qualify for lower monthly premiums through the ACA.
- Treasury Department Guidelines Clarify ACA Requirements
Regulations that clarify employer responsibility under the Affordable Care Act -- in particular, how the ACA applies to small businesses and whether certain part-time and full-time workers must have insurance coverage -- were issued last week by the U.S. Department of Treasury.
The guidelines specify that firms with 100 or more full-time employees will have to comply with the ACA next year while companies with 50 to 99 employees will have to comply starting in 2016.
Compliance will mean offering coverage to 70 percent of full-time workers next year and to 95 percent starting in 2016.
The final regulations issued also clarified that volunteers, such unpaid emergency responders and firefighters, are not considered full-time employees. It was also made clear that teachers and other school employees who don't work during the summer cannot be considered part-time;
Other parts of the regulations address how the ACA applies to seasonal workers and students in work-study programs.
- Interactive Map Offers Guide to ACA Help in Northern NJ
An interactive map of North Jersey showing where the most uninsured people reside and where they can get help signing up for health coverage through the Affordable Care Act, either through the health insurance marketplace or expanded Medicaid, has been made available by Enroll America.
The map of northern New Jersey is one of 22 detailed maps of major metropolitan areas issued by the healthcarwe enrollment coalition.
Less than six weeks remain in the first year's final period of open enrollment. Enroll America says the maps, based on information from the Department of Health and Human Services on ACA enrollment locations and confirmed by the coalition, will help allow organizations in New Jersey to quickly and easily target resources to help uninsured residents enroll before the deadline.
- Online Insurance Outfit: Dental savings Plans Can Fill ACA Gap
Sweeping changes in the nation's healthcare system under the Affordable Care Act are affecting how people are covered for dental care, according to the National Association of Dental Plans.
For example, while the ACA defines dental services as an Essential Health Benefit (EHB) for children, this does not mean that dental care will automatically be a part of a family’s insurance plan. Likewise, while dental coverage is available from some insurers in the ACA marketplace, it cannot be purchased separately as stand-alone coverage.
Dental savings plans, similar to a warehouse club, provides dental services for one annual fee, according to, which sells such coverage. Members can get reduced rates on dental services, cosmetic dentistry and orthodontia, as well as vision and prescriptions, depending on the plan they choose. Services may include annual cleanings, x-rays, crowns, root canals, and even cosmetic and orthodontic procedures, not typically covered by insurance.
- RWJ Hamilton Navigators Offer Help Signing Up for Coverage
Robert Wood Johnson University Hospital Hamilton (RWJ Hamilton) is offering free help for anyone who needs assistance enrolling for insurance available through the Affordable Care Act or navigating the healthcare.gov website.
Four sessions are being offered on the following dates, at these locations and times:
Saturday, February 15, and Saturday, February 22, 9 a.m. to 3 p.m., RWJ Fitness & Wellness Center, 3100 Quakerbridge Road, Hamilton.
Tuesday, February 18, and Tuesday, February 25, 3 p.m. to 6 p.m., RWJ Hamilton – Hospital Campus, One Hamilton Health Place, Hamilton.
To register to get in-person assistance from a Certified Application Counselor, call (609) 584-5900.
- NJ Congressman Asserts Obamacare Will Kill Millions of Jobs
U.S. Rep. Leonard Lance (R-7th) last week continued his criticism of the Affordable Care Act, citing a Congressional Budget Office report as proof that Obamacare’s mandates will lead to the elimination of millions of jobs.
In a press release, Lance stated:
“The non-partisan Congressional Budget Office projects that the President’s healthcare law will slow economic growth over the next decade, costing the Nation about 2.3 million jobs and contributing to a $1 trillion increase in projected deficits. And many Americans will see significantly reduced wages and hours worked because of the so-called Affordable Care Act.
"Republicans and some Democrats have repeatedly warned of Obamacare’s negative effects on the economy and that’s why we have fought vigorously for its repeal and replacement. Washington cannot continue to ignore Obamacare’s empty promises. Americans deserve real solutions that will improve our economy, rein in federal spending and protect the American people from the consequences of Obamacare.”
- Economic Group’s Disputes Claims that Obamacare Will Cost Jobs
Conservative critics of Obamacare have cited a recent report by the Congressional Budget Office as evidence that the Affordable Care Act will result in elimination of millions of jobs as employers required to provide more expensive and extensive health coverage are forced to lay off workers in order to maintain their profits.
A new report by the Economic Policy Institute disputes that interpretation of the numbers. It says, instead, that the CBO’s statistics reflect the number of people expected to voluntarily leave full-time jobs to pursue entrepreneurial or part-time opportunities newly available because they don’t have to rely on traditional employment to have affordable health insurance.
- Report Looks at Ways to Prevent Insurance Coverage ‘Churning’
The issue of “churning” – switching between health plans when patients whose eligibility for Medicaid and insurance coverage under the Affordable Care Act varies due to fluctuating income and changing family situations --- is addressed in a new report by the Center for Healthcare Strategies.
With millions of lower-income Americans taking advantage of coverage options available under the ACA, the CHS report says, the phenomenon of “churning” – which is common among Medicaid clients – is likely to become more prevalent. The report says adults who change health insurance coverage are less likely to have a regular source of medical care and tend to delay healthcare during coverage transitions.
The CHS white paper outlines ways state officials can help prevent residents from having temporary gaps in their coverage and looks at how some states “have sought to avoid interruptions in care for beneficiaries who transition across the new array of coverage options.”
- Planned Parenthood Gets $95K Grant for ACA Outreach, Sign-Ups in Essex County
Planned Parenthood of Metropolitan New Jersey (PPMNJ) has been awarded a $94,697 grant from The Healthcare Foundation of New Jersey to support Affordable Care Act enrollment, outreach and education in Essex County.
The Planned Parenthood branch aims to enroll more than 2,700 of its own eligible patients along with a target of 20,000 residents of the Greater Newark Area into Medicaid or a health plan available through the ACA.
PPMNJ became a “Marketplace-Designated Organization” in October 2013. A key aspect of the organization's effort to educate people about insurance options and to help them enroll was the training of Kalimah Johnson as a Certified Application Counselor.
Essex County has more than 130,263 uninsured residents, representing 13.1 percent of all uninsured residents in New Jersey. The county also has the state's largest number of uninsured children.
- Human Resources Group Hosts 'Complying with the ACA' Panel
A program on "Complying with the Affordable Healthcare Act" will be presented Thursday, February 13, at Jumping Brook Country Club in Neptune, hosted by The Jersey Shore Association for Human Resources (JSAHR).
Representatives of the Gallagher Bolliner insurance brokerage, the Employers Association of New Jersey (EANJ) and Horizon Blue Cross Blue Shield of NJ will take part in a panel discussion.
Prices are $40 for nonmembers, $30 for JSAHR members. Reservations must be made by February 6 to avoid a $10 late registration fee. Professional credits will be available.
For more information, call (973) 758-6800 or (609) 393-7100.
- Group Calls on Christie to Reject Expanded Medicaid
The state director of Americans for Prosperity, which describes itself as a national organiation that supports "restraining state and federal government growth and returning government to its constitutional limits," has called on Gov. Chris Christie to "rethink his position on Medicaid expansion."
Daryn Iwicki issued a statement Tuesday in which he cited a newly released Congressional Budget Office report on what the group described as "the federal healthcare insurance takeover and its impact on the nation’s labor market."
“AFP is calling on Gov. Christie to rethink his position on Medicaid expansion in lieu of today’s stunning Congressional Budget Office report. The CBO report makes it clear: provisions of ObamaCare, including the expansion of Medicaid, ‘will lead to a net reduction in the supply of labor’ and ‘reduce incentives to work’.”
“Every day we find out the impacts of this disastrous law on the lives and economic well-being of the American people are even worse than imagined," Iwicki said. "People are losing their plans, losing their doctors and facing crippling hikes in their premiums and deductibles -- while tens of thousands are also losing jobs or seeing their hours cut."
- Hospital in Montclair Sets Sessions Offering ACA Information, Sign-Ups
Need help navigating the various health-insurance options available through the Affordable Care Act?
Two free sessions offering answers to questions about ACA eligibility, coverage choices, costs and possible help with premium payments will be held at HackensackUMC Mountainside in Montclair on Saturday, February 8, from 10 a.m. to 1 p.m., and Tuesday, February 18, from 6 p.m. to 9 p.m.
Enrollment assistance will be available for those who choose to sign up for insurance that day.
The event will be held in the ground-floor auditorium at One Bay Avenue. Free parking will be available.
Advance registration is recommended. Call (973) 429-6012 or email email@example.com.
- Lance's Bill Seeks to Prevent ACA 'Bailout' of Insurers
Legislation that he says would prevent a "potential bailout" of the insurance industry is the Affordable Care Act doesn't meet cost projections has been introduced by U.S. Rep. Leonard Lance (R-7th).
Lance’s bill, H.R. 3851, would repeal two sections of the ACA that he says are designed to help cover insurance company losses.
One cornerstone of the ACA is signing up enough younger, healthier people to balance out the costs of insuring an older population. Lance believes the ACA won't enroll enough younger people, resulting in higher and big losses for insurers -- and what he predicts would be "another taxpayer-funded bailout."
- RWJ Hamilton Offers Help Applying for ACA Coverage
Help with enrolling in medical insurance coverage available through the Affordable Care Act is available from Robert Wood Johnson University Hospital Hamilton.
Certified application counselors, or “navigators,” can help people complete applications for coverage through the ACA website, www.healthcare.gov. To make an appointment, contact RWJ Hamilton’s Health Connection at (906) 584-5900.
- Veterans Help People Sign Up for Insurance Plans Under ACA
U.S. military veterans are serving on a new mission at Cape Regional Medical Center: They've been trained as Certified Application Counselors (CACs) to help people sign up for medical coverage available under the Affordable Care Act through the new health insurance marketplace, Medicaid and NJ FamilyCare.
Help is offered on Mondays and Fridays, with appointments available at 10 a.m., 11:30 a.m. and 1 p.m. by calling the medical center at (609) 463-4040.
Sponsors of the program include the New Jersey Hospital Association and New Jersey Health Initiatives, with financial support provided by a grant from the Robert Wood Johnson Foundation. The CACs are also working at other hospitals and sites around the state; visitfor more information about how to get help with insurance sign-ups.
- RWJ Partnership joins roster of Medicare ACOs
New Brunswick-basedhas been selected as one of 123 new Accountable Care Organizations (ACOs) in Medicare.
Doctors, hospitals and health care providers establish ACOs in order to work together to provide higher-quality coordinated care to their patients, while helping to slow increases in healthcare costs. Since passage of the Affordable Care Act, more than 360 (ACOs) have been established, serving over 5.3 million Americans with Medicare. ACOs share with Medicare any savings generated from lowering the growth in healthcare costs when they meet standards for high quality care.
- Disadvantaged patients likely to have minority doctors
Black, Hispanic and Asian physicians play an outsized role in the care of disadvantaged patients nationally. Patients who have low incomes, are from racial and ethnic minority backgrounds, have Medicaid insurance, or who do not speak English -- groups that historically have difficulty in accessing medical care -- are substantially more likely to receive their care from a minority physician, according to a new study appearing online in the current issue of the journal.
The study found that minority physicians care for 54 percent of minority patients and 70 percent of non-English-speaking patients. Other findings include: Asian, Hispanic and black patients were 19-26 times more likely to be cared for by a minority physician of their same race; low-income patients were 1 1/2 to 2 times more likely to be cared for by black, Hispanic and Asian physicians; and Medicaid patients were 2 to nearly 4 times more likely to see a minority doctor.
- New Publication Tracks ACA-Related Issues
The publisher of The American Journal of Managed Care has launched a new publication -- The American Journal of Accountable Care -- devoted to coverage of the implementation of the Affordable Care Act.
Thewill reach 40,000 healthcare professionals with peer-reviewed research on healthcare reform and "new pracices required by the transition to payment models keyed to measures of healthcare quality."
AJAC will also include coverage of major conferences that focus on new delivery systems and payment models. The inaugural issue covers the recent conference on Medicare, Medicaid and Dual Eligibles, sponsored by Americaís Health Insurance Plans, a strategic partner of AJMC.
- ACA Broadens, Eases Access to Medicaid Coverage
While 33 states allow community health centers, hospitals and schools to temporarily enroll children and pregnant women in Medicaid based on household income alone, the Affordable Care Act now allows many of those states to extend so-called "presumptive enrollment" to ll adults with incomes below 138 percent of federal poverty level.
The law also allows hospitals in every state to offer temporary, yet immediate, Medicaid coverage to patients who are likely to be eligible for government benefits.
A Robert Wood Johnson Foundationin more detail.
- Free Website, App Ease Access to Doctors
People newly insured under the Affordable Care Act can get help with finding in-network doctors, then making appointments, through a free online service called.
Noting that the ACA will "add millions of patients but no new doctors to the healthcare system," ZocDoc says that it can help with this problem by easing access to doctors, making the healthcare marketplaces more efficient.
Patients can fill out their paperwork online prior to their appointment, and physicians receive more complete and accurate patient information. The service can be accessed via ZocDoc.com or the free ZocDoc app for iPhone and Android. A Spanish-language version is also available.
- Fire, Rescue Volunteers Exempt from ACA Mandate
Volunteer firefighters and other local government and nonprofit emergency responders will be exempt from coverage mandates under the Affordable Care Act, it waws announced by the U.S. Department of Treasury. from triggering the coverage mandateówhich would require that they be provided affordable comprehensive health insurance.
Under the ACA, employers with 50 or more full time workers are required to offer affordable comprehensive health insurance or be subject to a penalty. Under the ACA, full time generally means 30 or more hours per week.
Counties served by volunteer fire departments were concerned that they might be required to offer comprehensive health coverage to their volunteers, forcing some departments to close.