Assemblyman Herb Conaway Jr. (D-Delran), chair of the Assembly health committee, said he expects the federal government to be ready this fall to launch the new exchange where thousands of uninsured New Jerseyans will buy government-subsidized health coverage from insurance companies under the Affordable Care Act.
Federal officials "are saying that they are on track," Conaway said. " I know that they have been working for over a year on the technical aspects of New Jersey's program," like building the IT infrastructure to enable health insurers and the state government to determine whether an individual is eligible for Medicaid or is entitled to a subsidy to buy a health plan on the exchange.
He said the system will be tested this summer, "and we will be ready to go when it's time to get people enrolled."
On Oct. 1, health insurers are supposed to start to sell subsidized health plans to individuals via the exchange, with the policies taking effect Jan. 1, when the ACA will require most Americans to either get health coverage or pay a penalty. Small employers with fewer than 50 workers also will be able to purchase policies on the exchange, and some will be eligible for tax credits to defray the cost.
Conaway's comments came as he addressed the Council on State Public Affairs' "New Jersey State of Health" symposium today at the Robert Wood Johnson Hamilton Center for Health and Wellness, in Hamilton.
Former Gov. Jim Florio expressed the widespread concern that the ACA is not doing enough to control health care costs, and predicted the administration that succeeds President Barack Obama is likely to revisit the ACA.
"I am comfortable saying that within the next five or six years, we will make another evaluation as to whether cost control is actually working," Florio said. "If not, we'll go back for another bite of the apple." He said the ACA retains a marketplace model to deliver health care, and noted there is a consolidation movement under way among hospitals, insurers and medical practices that could result in less competition.
Seton Hall Law School Professor John V. Jacobi said that between Medicaid expansion and the subsidized health plans to be sold on the exchange, "there will certainly be hundreds of thousands of people covered," among New Jersey's nearly 1 million uninsured.
"There are several barriers to getting those people covered, and one is the information deficit," Jacobi said. "People who are uninsured are typically very busy people who struggle to make their rent and put food on the table, and they are not engaged in the rollout of the ACA. So getting navigators and health educators and information to those people is going to be very important."
The federal Department of Health and Human Services has allocated $1.5 million to fund navigators in New Jersey, which health care experts have said won't be adequate.
Conaway said outreach to the public will be crucial. The state Department of Banking and Insurance still has an unspent federal grant of nearly $7.6 million it received to help plan a state-run exchange; the state opted instead for HHS to build the exchange for New Jersey. DOBI is talking to HHS about how that money can be used, and Conaway said it's key that navigators get that money.
"It's really going to be those community-based organizations that know how to reach and communicate with (the uninsured) that are going to be so important for reaching the people who need to be in the exchange," he said. "That certainly would be an appropriate use for that money."
Jacobi said the uninsured in New Jersey, "are mostly people associated with the workplace. Most are in families with workers, full-time or part-time workers, and dependents of workers," who either can't afford to buy insurance at their workplace, or their employer doesn't offer it.