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DOBI may be responsible for outreach on health exchange

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To help ensure thousands of New Jerseyans learn how to get government-subsidized health insurance under the Affordable Care Act, the Legislature may require the state Department of Banking and Insurance to lead a coordinated, statewide campaign to raise awareness about the health insurance exchange the federal government will launch in New Jersey on Oct. 1.

The bill directing DOBI to do consumer outreach, A-3878, is sponsored by Assemblyman Herb Conaway Jr. (D-Delran), chairman of the Assembly health committee. Sen. Nia H. Gill (D-Montclair), chair of the Senate commerce committee, said she will sponsor the bill in the Senate.

The Rutgers Center for State Health Policy estimated that in 2014, about 362,000 additional New Jersey individuals buy will coverage, of whom 254,000 will be eligible for a subsidy. The subsidies are an entitlement under the ACA, and are provided on a sliding scale based on income, with low-income residents getting significant coverage discounts. The subsidies phase out entirely at four times the federal poverty level, or about $94,000 for a family of four.

Gov. Chris Christie opted against creating a state-based exchange, the new online marketplace where individuals and small business will purchase subsidized health plans taking effect Jan. 1, when the ACA’s “individual mandate” requiring most Americans to get health insurance kicks in. The federal Department of Health and Human Services will provide exchanges in New Jersey and 25 other states. Christie twice vetoed bills to create a state-run exchange.

The ACA requires all exchanges, state or federal, to provide navigators — typically, community-based groups that can spread the word about the exchange and help people sign up for health coverage. HHS is expected soon to issue a “funding opportunity announcement” to award contracts to potential navigators. That announcement will detail the amount of money HHS will allocate to New Jersey for navigators. Gill said New Jersey would likely have been eligible for larger navigator funding had the state opted to run its own exchange, “and we could be further along in providing the structure for the exchange and educating the public.”  

New York is launching its own exchange, and will get about $40 million a year for the next few years from the federal government for marketing and outreach, of which $27.2 million will be spent annually on navigators, according to Peter Constantakes, spokesman for the New York State health department. He said New York estimates it will enroll more than 1 million people in its exchange: 615,000 individuals, and the rest small-business employees. New York also expects 500,000 additional residents to enroll in Medicaid, which is being expanded under the ACA.

The deadline for New York navigators to apply for funding is April 8, and they will start working Aug. 1. Entities eligible to serve as navigators include nonprofit groups, trade groups, chambers of commerce, and licensed insurance agents and brokers who aren’t compensated by health insurers.

Constantakes said the exchange marketing effort will include paid advertising. “We have hired firms to help us come up with a plan to fund media placement,” he said.  

Asked if New York might partner with New Jersey to market their exchanges, given that much of New Jersey is in the New York City media market, Constantakes said: “We have not contacted New Jersey because they are not running their own exchange.”

Dena Mottola Jaborska, of the consumer watchdog group New Jersey Citizen Action, said the DOBI exchange outreach bill, “is a good idea, but an effort needs to be made to work with the governor and ensure that the governor is on board with the idea, because we don’t want to see it vetoed.” 

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