A "premium alignment" bill advances in NJ legislature

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Will NJ's ACA marketplace glow as goldenly as its rest areas?

In June, I flagged a bill introduced in the New Jersey legislature this past spring, S3896/A5626, that would require silver plans in the state’s ACA marketplace to be priced roughly on par with gold plans in year 1 and on par with platinum plans in year two — reshaping a market in which gold plans have been priced out of reach for more than 98% of enrollees.

The bill’s logic is simple (though it has a complicated back story): On average, silver plans have a higher actuarial value than gold plans, since most silver plan enrollees qualify for the Cost Sharing Reduction (CSR) that attaches only to silver plans.

The bill was abruptly posted early this month for a December 11 hearing in the Assembly Financial Institutions and Insurance Committee, a committee chaired by one of the bill’s lead sponsors, John McKeon. The bill passed out of committee with no amendments on an 11-0 vote with one abstention. That’s first step in a gauntlet of three Assembly and two Senate committees’ consideration.

I testified in favor on behalf of BlueWave New Jersey, a progressive state advocacy group, along with Laura Waddell of New Jersey Citizen Action. My testimony is below.

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TESTIMONY BEFORE SENATE BUDGET AND APPROPRIATIONS COMMITTEE
December 11, 2023

A5626/S3896 would correct a severe pricing imbalance in New Jersey’s ACA marketplace that weakens coverage for middle-income enrollees in health plans offered on GetCoveredNJ.

New Jersey is unique among U.S. state marketplaces in that in New Jersey gold-level plans – the metal choice that offers a coverage level closest to the average employer-sponsored plans – are priced out of reach for almost all enrollees.  In New Jersey in 2023, just 1.5% of on-exchange enrollees selected gold plans, versus a national average of 11.9% (see CMS Public Use Files, Note 3).  Nationally, according to tables published by the Kaiser Family Foundation, the lowest-cost gold plan premium in each state market is 4% higher than the lowest-cost silver premium in 2024. In New Jersey, the lowest-cost gold premium is priced 37% above the lowest-cost silver plan.

In New Jersey, some protections from abortion criminalization and liability

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The New Jersey legislature has passed two bills designed to mitigate the state criminalization of abortion and state-authorized vigilante fascism enabled by the Supreme Court.

A3974 bars extradition from New Jersey for any "crime" as defined in other states that "relates to reproductive health services."

A3975* Bars New Jersey abortion providers and facilitators from disclosing any communication from those seeking reproductive services and any information obtained by examination. In particular, providers are barred from providing information or expending effort "in furtherance of any interstate investigation or proceeding seeking to impose civil or criminal liability upon a person or entity for receiving, providing, or abetting reproductive health services. It also provides that professional licensing boards in the state cannot penalize any provider for providing reproductive health services barred in another state if those services are legal in New Jersey.

The budget that goes to Governor Murphy for signature today includes $5 million for abortion provider training, $5 million for clinic security, $10 million for facility upgrades, etc. and $10 million more than allocated last year to family planning services. 

What did not pass, though some of its provisions and variations of those provisions are reflected in the items above, was a bill  (A4350/S2918) that would have mandated that health plans cover abortion (most in the state do), provided free abortions to the uninsured and undocumented, criminalized intimidation of those seeking or providing abortions, and provided even more robust legal protections to those seeking or providing abortion in the state. 

The language in the two bills described above, protecting out-of-state abortion recipients from extradition or disclosure of information to fuel criminal investigations or civil suits brought by vigilantes or other state governments, throws into sharp relief the patchwork hellscape of sexual fascism unleashed by the Supreme Court. 

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* I earlier summarized a superseded version of this bill. Apologies for the error. 

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Two NJ healthcare bills awaiting Gov. Murphy's signature should reduce premiums by 20-30% in the individual market

On April 12, both houses of the New Jersey legislature passed bills to establish a state individual mandate (A3380) and a reinsurance program (S1878). The bills are designed to work in tandem to stabilize and reduce premiums in the individual market for health insurance.

It is not certain that Governor Phil Murphy will sign the bills. A mandate is a tax, and taxes are hard. The reinsurance program will cost the state some money, though not much -- probably an amount in the low tens of millions each year. But the payoff would be dramatic. Taken together, as outlined below, the bills can be expected reduce premiums in the individual market 20-30% compared to what they would be if neither bill is enacted.