Category Archives: As a Matter of Fact

>As A Matter Of Fact…Proposed changes to NJ Medicaid program would wreak havoc on NJ FamilyCare

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June 9th, 2011 | Published in NJPP Blog: As a Matter of Fact …

Proposed changes to the state’s Medicaid program through a “waiver” of federal rules governing the program would wreak havoc on NJ FamilyCare, bringing the total number of uninsured parents in working poor families denied health coverage to 93,000 and touching every county in the state when prior cutbacks are also taken into account, according to an analysis by New Jersey Policy Perspective.

Essex and Hudson Counties have the highest number of uninsured adults losing coverage, but there are also substantial numbers of adults losing coverage in non-urban Ocean County and wealthier counties such as Morris and Somerset. The loss of an insurance option for those adults is likely to place greater pressure on other medical providers, such as hospital emergency rooms.

The data further showed that the exclusion of parents last year resulted in about 18,000 children not enrolling in FamilyCare, and the number would only increase as a result of new proposed new cutbacks in parent eligibility in the waiver.

Finally, while the stated purpose of the waiver is to maximize federal funding, the waiver would have the opposite effect for NJ FamilyCare. While closing enrollment would reduce state expenses by $9 million, it would cause the state to lose as much as $17 million in federal matching funds.

Continue reading…..Here

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Filed under As a Matter of Fact, federal funds, Gov. Chris Christie, Medicaid, New Jersey Policy Perspective, NJ FamilyCare

>As a Matter Of Fact…State losing out on 9-1 match;NJ would save $45 million a year if it invested $7.5 million in family planning

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May 23rd, 2011 | Published in NJPP Blog: As a Matter of Fact …

At a time when New Jersey doesn’t have a penny to spare, the state is leaving money on the table – perhaps millions of dollars a year in federal funds that could provide family planning services to poor, uninsured women.

Not only has Governor Christie refused to continue the program that provides state grants to family planning clinics across the state (he vetoed a $7.5 million appropriation sponsored by Sen. Weinberg), the state has withdrawn its application for a Medicaid waiver that would have provided a 9-to-1 federal match of state funds that paid family planning expenses for women at or below 200% of the federal poverty level. To put it in simpler terms, under the waiver known as the Family Planning State Option the federal government would provide $9 million for every $1 million that New Jersey spent.

According to estimates from the widely-respected Guttmacher Institute, the Family Planning State Option would save New Jersey $3 million in the first year alone. After the first year, it would:

• Save the state $45 million every year.
• Provide basic medical care to over 80,000 people every year, including not just family planning but other preventive care such as cancer screenings.

• Help thousands of low income women who want to avoid pregnancy do just that – averting 4,000 abortions and 6,000 births every year.

See the full report here.

Twenty-eight states currently receive matching funds and all have seen substantial cost savings. According to estimates by the National Academy of Health Safety Policy, the savings over five years range from $75 million in Arkansas to more than $2 billion in California.

See the full report here.

The governor has said his opposition to the family planning clinic grants has nothing to do with politics, but is based in his desire to be a responsible fiscal steward of the state’s scarce resources.

He should live up to that standard.

Clearly, the numbers show the tremendous benefit that accrues by funding these grants. In addition to providing poor and working women broad and consistent access to family planning services, the Medicaid waiver allows the state to receive the 9-to-1 federal match in funding.

The fiscally responsible thing to do would be to invest a little of the state’s resources in family planning and reap the rewards of increased federal funding as well as cost savings to deal with avoidable pregnancies.

To do anything else seems to be a waste of time and money.

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Filed under As a Matter of Fact, blog, family planning, federal matching funds, Gov. Chris Christie, Medicaid, New Jersey Policy Perspective, women's health issues

>As A Matter Of Fact…Taking the family out of NJ FamilyCare

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May 17th, 2011 | Published in NJPP Blog: As a Matter of Fact …


In defense of his plan to cut the state’s federally subsidized health insurance program for working poor families, Governor Christie recently asserted that New Jersey provides more access to Medicaid than any state except New York.

That’s simply not true.

In fact, if the governor has his way, New Jersey would have one of the nation’s most restrictive policies when it comes to the Medicaid program that provides affordable health insurance to working poor families who have no other options.

It is accurate to say that when it comes to children New Jersey is second only to New York in providing health coverage through Medicaid/ NJ FamilyCare. However, when it comes to providing affordable coverage to the rest of the family, Medicaid/NJ FamilyCare lags behind nine other states and is racing toward the bottom of that list.

Last year, the state cut the NJ FamilyCare eligibility level for parents in New Jersey from 200 percent of the Federal Poverty Level (FPL) to 133 percent of FPL. For a family of three, that meant a maximum yearly income of $25,000 instead of $36,000.

The state plans even further reductions this year by reducing that eligibility threshold to just 29 percent of FPL. That’s a yearly income of about $5,300 for a family of three. That’s also the same eligibility level for the welfare program, WorkFirst NJ. The irony there is that taking away the option of NJ FamilyCare creates an incentive for parents to stop working full time and rely on welfare in order to have health insurance.

If those proposed cuts are enacted, New Jersey would have one of the lowest eligibility levels for parents in the nation. Only Alabama, Arkansas, Louisiana, Missouri and Texas would have lower eligibility levels.

More important, however, is that research in New Jersey and nationally has shown that reducing the eligibility level for parents will reduce the number of children enrolled in NJ FamilyCare. That will only increase the financial pressures on emergency rooms and hospitals as it drives up the number of uninsured New Jerseyans.

Read more about family health insurance here.

View the press event with Senators Joseph Vitale and Loretta Weinberg and advocates on this issue along with the governor’s response.

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Filed under As a Matter of Fact, Gov. Chris Christie, health reform, Medicaid, New Jersey Policy Perspective, NJ.com, NJFamilyCare

>As A Matter Of Fact…A fair exchange: Consumer driven health insurance

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May 9th, 2011 | Published in NJPP Blog: As a Matter of Fact …

One of the most important provisions of the Patient Protection and Affordable Care Act (ACA) is the establishment in every state of a health insurance market place, called an “exchange.”

These exchanges will allow individuals and small businesses to easily find and compare options for high quality, comprehensive health insurance. If done properly, the exchanges will increase competition in the insurance market and, in turn, lower the cost of insurance for nearly 800,000 uninsured New Jerseyans who must find coverage under the terms of the Affordable Care Act. The exchanges will also make available information about services and subsidies available to low and moderate income families.

While the federal government has set certain standards for exchanges, the Affordable Care Act offers each state broad flexibility to design its own exchange. The federal government will provide funding to operate exchanges until January 2015, when all of the exchanges must become self-sustaining. If the state has not established an exchange by then, the federal government will establish one for the state.

That process of creating an exchange has already begun in New Jersey.

The state, through its Working Group on the Patient Protection & Affordable Care Act and under a federal grant, has contracted with the Rutgers University Center for State Health Policy to seek input on priorities the state should consider for the implementation of key provisions of the ACA. As part of its information gathering effort, CSHP is asking interested parties to participate in a web-based survey on the design of an exchange for New Jersey by May 11. The CHSP’s report is expected to be made public later this year.

The Legislature has also set to work. The state Senate held an informational hearing last month and three bills have been introduced to establish the basic structure of an exchange (S2553, S1288 and S2597). Much of the public discussion of the details of the final legislation will take place in the Legislature’s health and insurance committees.

One of the key issues up for discussion is the extent to which the exchanges represent the interests of consumers.

For example, the exchange can be a wide-open marketplace where all insurers may participate, regardless of how much they charge or whether they meet minimal standards to protect consumers. Because the Affordable Care Act requires everyone who is uninsured to purchase insurance, that unregulated approach might leave consumers vulnerable. Alternately, the exchange could operate as an “active purchaser.” In that role, the exchange would only allow insurers to participate if they could demonstrate that their rates are reasonable and they meet other standards aimed at protecting consumers. A similar issue involves the requirements for members of the board that will ultimately oversee the exchange. Most boards are expected to be small, so decision-making will be more manageable. That makes the composition of the board a key point. Some states are establishing very strong requirements to prohibit conflicts of interest for members of the board while others go further and ban insurers, brokers and other representatives of the health care industry. Because of the importance of the exchange to consumers, the NJ for Health Care Coalition developed a set of principles recently that should be used as a guide in finalizing any legislation on exchanges. The coalition represents a broad alliance of 68 health care, consumer and social justice organizations (including NJPP) with more than two million members. It believes the public should understand the choices being made and should actively support the principles as established by the coalition to ensure that the health care exchange in New Jersey represents consumers over special interests.

Following are the principles as adopted by the coalition:

Public Interest Mission – The New Jersey Exchange should be established in the public interest, for the benefit of the people and businesses who obtain health insurance coverage for themselves, their families and their employees. It should empower consumers by giving them the information and tools they need to make sound insurance choices. The Exchange should work to reduce the number of uninsured, improve health care quality, eliminate health disparities, control costs, and ensure access to affordable, quality, accountable care across the state.

Independent Public Exchange – The Exchange should be a distinct legal public entity that is independent of other units of state government. It should be able to perform inherently governmental functions like determining income eligibility, coordinating with other state agencies and programs, and adopt rules and policies governing health insurance plan participation. The Exchange must be transparent and subject to open meetings and public disclosure laws.

Qualified, Pro-Consumer Governing Board – Consumer representatives should comprise a majority of the board. All board members must have expertise in one or more of the following areas: consumer advocacy, individual health care coverage, small employer health care coverage, health benefits plan administration and health care finance. The governing board may not include members who are affiliated with the health care industry.

Negotiate on Behalf of Consumers – The exchange must be given the authority to act as an “active purchaser.” This means the Exchange should use its large pool of consumers to negotiate, as large groups do, for the best premiums and plans. The Exchange must use this leverage to demand quality, responsiveness to consumer concerns, reasonable rates, efficient plan designs, robust provider networks and comprehensive benefits.

Full Integration with Medicaid and NJ FamilyCare – To promote seamlessness in the application process and continuity in coverage, the Exchange plans must be fully coordinated and integrated with Medicaid and NJ FamilyCare. Plans that are available in Medicaid and NJ FamilyCare must also be available in the Exchange.

Consumer Friendly – The Exchange must be easily accessible to all consumers and small businesses, use plain, easy-to-understand language and meet established standards for language, literacy and cultural competency. The Exchange must adopt a “no wrong door” approach, meaning people can access insurance through the exchange no matter how they come to seek assistance. It must reduce paperwork for individuals and small businesses, and provide in-person, telephone and online assistance and access.

Effective Outreach and Assistance – The Exchange should contract with independent organizations that will help consumers and small groups “navigate” the various health insurance plans and services offered through the Exchange. Contractors providing these navigator programs should be free of insurer conflicts of interest and have a history of working with diverse communities. The exchange must also provide customer service that understands diverse populations, such as people with disabilities, mental health needs or low-income.

One Insurance Pool – Health insurance markets work best when risk is shared across large numbers of people. The Exchange should explore how best to transition toward a unified insurance pool that combines both the individual and small employer markets. Other opportunities to expand the pool of insured people should be explored.

Improve Health Care Quality & Promote Prevention – The Exchange should only offer plans that provide a comprehensive and high-quality package of health care services. Every plan should prioritize prevention and work to reduce health disparities. Dental and mental health benefits should be included. Health care delivery networks should include essential community providers. Patients should have access to providers who speak their native language.

Community Health – The Exchange itself should promote community health by fostering collaborations between the Exchange insurers and community organizations, such as local public health departments, mental health associations, maternal and child health consortia and disease-specific nonprofits. This will ensure the efficient delivery of health information, health promotion and disease prevention and screening services.

Ensuring Exchange Stability– The State must guard against the segregation of people by their health status. Premiums in the exchange could become very expensive if insurers and brokers have the power to steer less-healthy patients into the Exchange, keeping for themselves only healthier, more profitable enrollees. The same rules must apply to plans both inside and outside of the Exchange. The Exchange must set market protections to prevent insurers and brokers from cherry-picking healthy enrollees or steering them into or out the exchange.

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Filed under As a Matter of Fact, Consumer Driven Health Insurance(CDHI), health insurance, Insurance exchange, New Jersey Policy Perspective, NJ FamilyCare, Rutgers University, The Affordable Care Act

>As A Matter Of Fact…State pleads poverty to reduce tax credits for working families, but has enough to provide tax credits for corporations

>April 18th, 2011

For working families struggling to make ends meet, the state Earned Income Tax Credit is a necessity, and the Christie Administration’s 25 percent reduction in the credit this year for about a half million New Jersey families is a devastating increase in the taxes they owe.

Today, on tax day, it’s important to note that a parent with two children working full time at the minimum wage of $7.25 an hour (about $15,000 a year) will owe $300 more in taxes – or more than a week’s wages.

These are the same families who are also being targeted for other cuts in services that are essential to their independence. Last year about 48,000 uninsured parents who received the state EITC were denied health coverage through NJFamilyCare. That number is expected to rise to 92,000 parents this year.

It is getting to the point in New Jersey where, for many marginal families, it simply doesn’t pay to work. Aside from stripping those working families of their independence, it creates an even greater cost to the state.

The governor’s favorite rock star, Bruce Springsteen, recently cited a Legal Services of New Jersey report in a letter to the Asbury Park Press, writing, “the cuts are eating away at the lower edges of the middle class, not just those already classified as in poverty, and are likely to continue to get worse over the next few years.” The census data backs up his assertion. From 2005 to 2009 lower income groups increased, the middle class shrank and the number of wealthier people increased in New Jersey. Economics plays a role in this, but so does state policy.

This cutback in tax credits for working families comes even as the Christie administration and the Legislature are expanding tax credits for corporations in New Jersey.

For example, last month the state awarded Campbell Soup a $41 million tax credit to renovate its corporate headquarters, move 49 jobs from Cherry Hill to Camden and hire 50 new employees at the Camden site over the next 10 years. The credit includes $6.3 million for new furniture. Campbell qualifies for the subsidy, officially called the Urban Transit Hub Tax Credit, which is aimed at redeveloping urban centers, because its offices are within a mile of the Walter Rand Transportation Center.

The total cost to the state to fund that tax credit to Campbell Soup is nearly as much as the $45 million in savings gained by reducing the state EITC.

So who needs this help the most, one of the largest corporation in America or working New Jerseyans who can barely make ends meet to support their children? It’s unfortunate example of why the state needs a more balanced approach — one that doesn’t focus only on cuts in services, but also balances the demand for shared sacrifice fairly between working families and giant corporations.

Interested in learning more about the Earned Income Tax Credit? Check out this piece by the Center on Budget and Policy Priorities:

A Hand Up: How State Earned Income Tax Credits Help Working Families Escape Poverty in 2011

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Filed under As a Matter of Fact, blog, Bruce Springsteen, corporate tax breaks, Earned Income Tax Credit, Gov. Chris Christie, New Jersey Policy Perspective, NJFamilyCare, poverty

>As A Matter Of Fact…..Budget hearings on the economy and State revenue collections

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This week, the legislature will begin to consider Governor Christie’s proposed FY 2012 budget. This is traditionally the time when the State Treasurer and the Legislative Budget and Finance Officer (LBFO) present their assessment of the state’s economy and what that means in terms of revenue collections for this year and the next. Today, State Treasurer Andrew Sidamon-Eristoff and LBFO David Rosen addressed the Senate Budget and Appropriations Committee; tomorrow, they will address the Assembly Budget Committee. Both of these full-day budget sessions traditionally are broadcast online.

The seven taxes in the table below account for eighty percent or more of the revenue collected by the state. It compares actual revenues collected in FY 2008 and FY 2010 to the amounts Governor Christie is using as a basis for his FY 2012 proposed budget. In an earlier blog, Taking the Long View, we outlined why it is appropriate to consider state collections and spending over a longer period of time than the year-to-year manner of the Governor’s annual budget. Suffice it to say, these are unprecedented times and we need a clear understanding of the situation.

In FY 2008, the state collected and spent more money than in any other year. Then the recession hit and revenues dropped precipitously. The FY 2008 and FY 2010 tax rates and structures are roughly comparable in those two years, i.e. no major increases or decreases were enacted in FY 2008 or FY 2010. Governor Christie is proposing a budget that also includes no significant rate changes.

The one rate change impact would be from the calendar year 2009 income rate increases on taxpayers earning more than $400,000. This likely had a residual effect on income tax collections in FY 2010. This is because higher income taxpayers tend to settle their tax bills in April and in 2009 their tax bills would have been higher (so additional calendar year 2009 taxes that are due would have been paid in FY 2010).

To understand more about state revenues and what these numbers mean, tune in to the hearings and look for Treasurer Sidamon-Eristoff and LBFO David Rosen’s testimony.

Note: NJJP’s “As a Matter of Fact” blog has taken the place of NJJP’s Monday Minute and will be posted here from time to time.

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Filed under As a Matter of Fact, blogs, Budget, budget hearing, Gov. Chris Christie, New Jersey Policy Perspective, Newsletter, tax collections