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NJ extends deadline for insurers' ACA filings

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“Despite actions taken at the federal level to undermine the Affordable Care Act, New Jersey is working aggressively to create stability in the market and to ensure that residents have access to affordable quality health care.” -- DOBI Commissioner Marlene Caride
“Despite actions taken at the federal level to undermine the Affordable Care Act, New Jersey is working aggressively to create stability in the market and to ensure that residents have access to affordable quality health care.” -- DOBI Commissioner Marlene Caride - ()

The New Jersey Department of Banking and Insurance has extended by a week the deadline for health insurers to file 2019 Obamacare premiums, to July 18.

A memo advising insurers of the extension also notes insurers should calculate as if currently frozen risk-adjustment payments were restored by next year.

“Despite actions taken at the federal level to undermine the Affordable Care Act, New Jersey is working aggressively to create stability in the market and to ensure that residents have access to affordable quality health care,” DOBI Commissioner Marlene Caride said in the memo, dated July 9.

The move is the latest by New Jersey to grapple with the continually growing uncertainty over the nationwide health care market under the Trump administration. DOBI alerted media to the memo and also offered a statement from Caride on the issues.

“The decision to halt risk-adjustment payments is another attempt by the federal government to create uncertainty in the market and was announced days before rates are due for the 2019 plan year in our state,” Caride said in the statement.

On July 7, the federal Centers for Medicare and Medicaid Services said it put $10.4 billion in risk adjustment payments and collections on hold. The move came in response to a New Mexico district court ruling barring the CMS from collecting or making those payments under their current methodology.

“CMS has asked the court to reconsider its ruling and hopes for a prompt resolution that allows CMS to prevent more adverse impacts on Americans who receive their insurance in the individual and small group markets,” CMS Administrator Seema Verma said.

Risk adjustment is a pot of money pooled together by insurers’ payments. Those funds are redistributed to insurers for taking on higher-cost members. The anticipated funds are built into how insurers calculate their premiums for the next year.

“Without a quick resolution to this matter, this action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in fewer health plan choices,” said the Blue Cross Blue Shield Association in a subsequent statement.

In May, Gov. Phil Murphy signed a law enacting an individual health care mandate, which would require New Jersey residents to have health coverage or pay a penalty mirroring the ones put in place under the ACA prior to the federal repeal. The mandate goes into effect Jan. 1, at the same time that the federal individual mandate is slated to end.

Funds from those penalties will go towards a health care reinsurance fund, which Murphy also signed into law, which is aimed at offsetting the costs of more expensive treatments.

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Daniel J. Munoz

Daniel J. Munoz


Daniel Munoz covers politics and state government for NJBIZ. You can contact him at dmunoz@njbiz.com.

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