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N.J. gets $22.6M to keep NJ Protect program running to year's end

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New Jersey is getting $22.6 million from the federal government to continue operating NJ Protect — the state's health insurance program for individuals with pre-existing conditions — that will keep the 1,520 people enrolled in the program covered through the end of the year.

On Jan. 1, 2014, the federal Affordable Care Act eliminates pre-existing conditions as an obstacle to purchasing health insurance, meaning it won't be necessary.

Banking and Insurance Commissioner Ken Kobylowski cheered the move as a way for those enrolled in the program to "be assured that their premiums will not rise for the remainder of the year."

Pre-existing condition insurance plans, called PCIPs, were created in all states in 2010 for those with pre-existing illnesses, like cancer and diabetes, who had not had health insurance for six months. States had the option of operating their own PCIPs or letting the federal government run the program; New Jersey introduced NJ Protect in August 2010.

In February, the federal Department of Health and Human Services informed PCIP contractors nationwide to cease accepting new enrollment within 15 days, and March 1 as the final date consumers could submit new applications for NJ Protect. Kobylowski asked HHS Secretary Kathleen Sebelius to reconsider the ban on new enrollees, which HHS declined.

New Jersey has worked with its PCIP carriers to continue operating its own program, rather than allowing it to default to a federally operated program. The two insurance carriers participating in NJ Protect, AmeriHealth New Jersey and Horizon Blue Cross Blue Shield of New Jersey, agreed to continue with the state-run program.

"We felt very strongly that the state and its New Jersey carriers could do a better job running the program," Kobylowski said in prepared remarks. "New Jersey's program has operated far more efficiently than many other states' PCIP programs. Also, by keeping the program in New Jersey, we were ensuring that those enrolled in NJ Protect could keep their doctors and provider networks."

AmeriHealth New Jersey said it has extended NJ Protect for members currently enrolled in the program through the end of this year.

"NJ Protect is aligned with our mission to enable the people of New Jersey to improve their health and well-being while helping them gain access to affordable, quality care," said Mike Munoz, senior vice president of sales and marketing for AmeriHealth New Jersey.

When NJ Protect closes Dec. 31, those enrolled in the program will be eligible to purchase health insurance on the new state health insurance exchange that is now being created by HHS under the Affordable Care Act. Both Horizon and AmeriHealth New Jersey have announced they will participate in that exchange.

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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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