NJTV
NJTV News
Watch

NJ Pays Highest Health Insurance Premiums Through Obamacare

6-18-14

By Christie Duffy
Correspondent

New Jerseyans pay more for health insurance than most other places in the country. That’s according to a new report issued by the Department of Health and Human Services.

“The real difference is that the cost of services in New Jersey is higher — the cost of doctors, the cost of hospitals,” said New Jersey Association of Health Plans President Wardell Sanders.

According to the federal report, New Jerseyans pay an average premium of $148 per month. That’s 55 percent higher than the average $82 premium paid in all the other states in the federally-facilitated marketplace.

“Looking at Medicare data, other sources, it’s pretty consistent. We use more specialty care here, we use more hospital care, particularly toward the end of life, people with chronic conditions, more hospital re-admissions than elsewhere. A lot of those indicators are improving but they are improving elsewhere too so we remain an outlier on cost,” explained Joel Cantor, director of the Center for State Health Policy at Rutgers University.

New Jerseyans do get more subsidies to help pay for our high premium costs than many other places. But some say that those subsidies may not last if the cost of health care is not brought under control.

One solution that’s getting a lot of attention is a model of care some like to call “concierge care for the masses.”

“For example, helping people manage their own chronic conditions, that’s a huge driver of cost. If I have diabetes for example and I end up in the hospital repeatedly because my blood sugar gets out of whack, I need to learn how to manage that better. But the primary care doctors also need to be available more. Off hours availability, telephone availability, phone calls from the office to remind me to take my medicine, fill my prescription and so on. And those kinds of things are just really starting to ramp up,” said Cantor.

“It’s really changing the way care is delivered and paid for. Better coordination, better dialogue between payers and it’s very patient centric,” Sanders said.

Sanders also says that New Jersey needs to step in on out-of-control emergency room price gouging.

Some say health care costs need to be made more transparent, so the consumer can shop around and make more savvy choices.

“It’s very difficult for a consumer to call around to get any type of information,” said New Jersey Health Care Quality Institute Vice President Linda Schwimmer. “We’re going to go to a more consumer driven market where consumers are gonna need to know what they are purchasing, how much it’s gonna cost them, what are their options and what’s the quality of what they are getting.”

And Schwimmer says those big subsidies we’re getting to help shoulder the cost may not be sustainable. She thinks bigger subsidies should go to the insurance plans that do the most to lower health care costs.