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Obama's ACA reversal now in hands of N.J. insurance regulators

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The immediate future of the ACA in N.J. is in the hands of the Department of Banking and Insurance.
The immediate future of the ACA in N.J. is in the hands of the Department of Banking and Insurance. - ()

By Beth Fitzgerald | Email | Twitter | Facebook

Forget the president, Congress —and even that can't-quite-work-right web site.

The immediate future of the Affordable Care Act in New Jersey now appears to be in the hands of the Department of Banking and Insurance (DOBI).

This agency will determine whether it is even possible at this late date to do as President Obama desires and allow policyholders to, in fact, keep their plans if they like them.

Ward Sanders, president of the New Jersey Association of Health Plans, said it won't be so easy logistically for insurers to restore the basic and essential (B&E) coverage that has been cancelled.

"(The insurers) can't issue plans without rates," Sanders said. "They have to develop rates and file them and they have to be vetted by DOBI, and it doesn't happen with the flip of a switch; it takes time."

Because the B&E plans were supposed to disappear on Dec. 31, insurers did not figure out rates for B&E plans — let alone file them with DOBI, Sanders said.

Obama's decision to allow insurance companies to let Americans keep their old health plans for one year applies to both the individual market and to the small group market — for employers with fewer than 50 workers — according to a letter the federal government sent to state insurance commissioners Thursday.

Today insurance brokers said they are waiting to learn whether the state Department of Banking and Insurance (DOBI) and the state's insurance companies will carry out Obama's request.

But as insurance broker David Oscar of Altigro pointed out, this is voluntary. DOBI "has to talk to the insurance carriers and see if it is possible" to revive the old plans.

Sanders said there are 650,000 people in the New Jersey small group market and 150,000 in the individual market — and about 100,000 members of the individual market have these B&E plans.

Frank Ruggiero, director of broker education at the insurance brokerage Slattery GA, said creating a new policy — or even restoring the old ones — will take time.

"The insurers have retooled and modified their products to meet all the rules and regs (of the ACA)," he said. "And now, 45 days before that, (Obama) is saying you are allowed to keep (the old policies). Will DOBI allow them to maintain those policies?"

At this point, DOBI will only say it is trying to get a grasp on the situation.

"The department is reviewing detailed information regarding ACA implementation received from CMS as outlined by the president," spokesman Marshall McKnight said.

Of course, what it decides for this year is just one part of the problem.

"What bothers me is it's only a transitional relief period (for one year)," Ruggerio said. "So what have they done except create a lot of confusion?"

If New Jersey goes along with Obama's plan, the question remains whether there is enough time for insurers to retool their systems once again so customers can keep the old plans.

"The insurance carriers don't want to have a fiasco similar to healthcare.gov come the first of the year," Ruggiero said.

Insurance broker Eileen Shrem has individual and small group clients, and nearly all are facing higher rates under Obamacare, which mandates more extensive and more costly benefits.

Shrem said her clients will have to decide whether to keep their old, cheaper policies if they get that option.

"But we have to change (the plans) eventually," she said. "Putting it off a year isn't going to do anything."


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