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Cancer advocates lead calls for Washington to restart NJ Protect enrollment

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Cancer advocates are urging the federal government to allow New Jerseyans to continue enrolling in NJ Protect, a government-subsidized health insurance plan for people with existing medical conditions.

Once the federal Affordable Care Act takes effect Jan. 1, insurers won't be able to refuse to cover existing medical conditions. Until then, New Jersey insurers can require new members to wait 12 months before an existing condition is covered.

NJ Protect, by comparison, covers existing conditions from day one. Through Jan. 31, 2013, New Jersey has received $49.3 million in federal subsidies to help cover the cost of NJ Protect policies, which are sold by Horizon Blue Cross Blue Shield of New Jersey and AmeriHealth NJ.

Launched in 2010, the program now has 1,423 members; it was closed to new applicants March 1.

"NJ Protect was a viable option for lower-income, higher risk individuals in the state of New Jersey," said Mike Munoz, senior vice president of sales and marketing for AmeriHealth New Jersey. "If the decision was made to extend enrollment through the end of the year, we would support that."

Ken Kobylowski

Last month, acting Insurance Commissioner Ken Kobylowski asked federal Health and Human Services Secretary Kathleen Sebelius to extend enrollment in the program beyond March 1, pointing out that New Jersey has used less than the $141 million earmarked for the state; nationwide, the $5 billion program for those with existing conditions now covers 100,000 Americans.

Kobylowski said if the program had "been run in every state as well as it has been run in New Jersey, it would not be in danger of running out of federal funding on the national level."

Last week, a coalition of cancer advocacy groups, the NJ State Patients Equal Access Coalition, wrote to Sebelius to urge her to reopen enrollment for NJ Protect through the end of this year, as with enrollment frozen, "cancer patients looking for insurance coverage could be subject to a 12-month waiting period, where they would be unable to receive the life saving care they need."

It's not possible right now, according to HHS.

In a letter to Kobylowski dated March 1, Marilyn Tavenner, acting administrator of the HHS Centers for Medicare and Medicaid Services, said, "While we would like to extend coverage to as many New Jersey residents as possible, the limited nature of the funds provided by Congress for this purpose prevent us at this time from extending such coverage beyond those already receiving it. Should the funding outlook change, we may reopen enrollment."

Ethan Hasbrouck, New Jersey state advocacy director for the American Cancer Society, pointed out the costly nature of a condition like cancer.

"Cancer is one of the most expensive diseases to treat and to live with, and without health coverage, you run through all your assets quickly, and a lot of care falls onto charity care," he said. "The financial toll of cancer is devastating to individuals and their families."

Jennifer Sullivan, who represents the International Myeloma Foundation, said without NJ Protect, an uninsured patient diagnosed with cancer might purchase more expensive coverage in the individual market, but still have to wait up to 12 months before their cancer is covered by that policy.

"If you are uninsured, you are less likely to get good care, or care at all, for cancer," Sullivan said.

Premiums for NJ Protect vary by age and the type of plan purchased. For example, one plan is $245 a month for someone younger than 25, while another plan is $813 a month for someone age 60.

Beth Fitzgerald

Beth Fitzgerald

Beth Fitzgerald reports on health care, small business and higher education. She joined NJBIZ in 2008 after a 34-year career at the Star-Ledger and has been reporting on business in New Jersey since 1978. Her email is beth@njbiz.com and she is @bethfitzgerald8 on Twitter.

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