There may be an updated federal health insurance website, as well as 24/7 phone support, but it remains an open question whether uninsured New Jersey residents will even know that subsidized health insurance is available for them to purchase, let alone that they are required to buy it.
Federal officials have been reaching out to local administrators and nonprofit health advocates in states like New Jersey, which opted for a federal health insurance marketplace, formerly known as an exchange until the government renamed it earlier this year.
But don't expect the feds to call on the Christie administration, which won't be playing an active role in publicizing the marketplace. Gov. Chris Christie vetoed a bill that would have required state-level public outreach to inform residents about the website.
In the absence of support from the Christie administration, the feds are looking to New Jersey healthcare resources to get the word out.
"You’re going to playing a very critical role not only in delivering quality healthcare, but helping people understand what’s involved in the Affordable Care Act, and what will benefit them,” federal Health Reform Office Director Michael Hash told a gathering of healthcare officials on June 26.
The marketplace will allow residents to purchase insurance online and will inform them whether they are eligible for insurance subsidies. These are targeted to residents with incomes between 138 percent and 400 percent of the poverty line, or between $15,856 and $45,960 for single residents and between $21,430 and $62,040 for couples.
Thethat will be the home of the marketplace was updated recently to allow residents to receive a customized checklist of information they'll need to enroll for insurance. Enrollment is scheduled to begin on October 1, with coverage, beginning on January 1, 2014.
Under the ACA's individual mandate, residents will be required to purchase insurance by the end of the open enrollment period in March or pay a $95 penalty on their 2014 tax return. That penalty will rise to $325 in 2015 and $695 in 2016.
Hash highlighted some of the provisions of the ACA, including the end-of-lifetime limits on coverage for 105 million Americans; preventive healthcare without cost-sharing for 71 million; and health insurance under parents’ plans for 3.1 million adults through age 26.
“Where there were dysfunctional insurance markets -- both individual and small group -- we are creating new competitive marketplaces that will offer high-quality options to individuals who are seeking coverage,” Hash said.
Critics have countered that the law remains unpopular in opinion polls and amounts to unnecessary intrusion in the healthcare system.
Since the drafters of the ACA expected that states would choose to operate their own exchanges, they set aside a large amount of money for public outreach, but relatively little for federally run exchanges. For example, Maryland has $24 million for outreach, while New Jersey – with a larger population -- has been allocated $1.5 million.
Professional sports teams are another possible conduit for publicizing the marketplaces. Hash noted that the Boston Red Sox were important in publicizing health insurance in Massachusetts, the first state that mandated universal health coverage. While federal officials have said they are in talks with the National Football League, Republican members of Congress have asked pro sports leagues not to participate, saying that the health reform program is divisive.
The outreach funding is a cause for uncertainty for healthcare advocates in the state. Maura Collinsgru, health policy advocate for the nonprofit New Jersey Citizen Action, said: “One of our biggest concerns is that New Jersey is seriously under-resourced.”
Citizen Action has joined other groups in askingfor outreach. The state has been in talks with the federal government over the issue.
Collinsgru added that healthcare providers might play an important role in conducting public outreach for the marketplace.
In addition to sports leagues, federal officials have been focusing on social media networks.
“We want to meet [young people] where they are with the information and raise their awareness, and get them motivated to come in and sign up for coverage,” Hash said.
Another crucial link that may become vital to publicizing the exchange is local health officials. James Allen, spokesman for Newark Mayor Cory Booker, said city officials have been in contact with the federal government about encouraging residents to enroll for insurance through the exchange.
“We are working with the feds and we’re going to be partnering with nonprofit groups, community organizations, and others in the community to direct residents” to the marketplace, Allen said.
Hash said federal officials want the marketplace to be a “seamless” experience for residents who will visit the site and fill out a single application that will direct them to one of several sources of coverage, including the Medicaid program for low-income residents. Applicants will be able apply online, by phone, and in person.