Fifty years ago today, President Lyndon Johnson signed legislation that established Medicare for seniors and Medicaid for the poor. Back then, comprehensive health insurance was criticized as “socialized medicine.” Fifty years later, it covers half of our country’s births, one-third of our children and two-thirds of our elderly and disabled in nursing homes. Over 50 years, Medicaid has become the nation’s largest source of health care, covering nearly 70 million low-income Americans — children, working parents, our poorest seniors, pregnant women and the 10 million people covered by Medicaid expansion under the Affordable Care Act. U.S. Department of Health and Human Services Regional Director Jackie Cornell-Bechelli told NJTV News Anchor Mary Alice Williams that about 1.7 million New Jerseyans are covered through Medicaid and 1.5 million on Medicare.
When asked about the impact of Gov. Chris Christie’s decision to expand Medicaid under the Affordable Care Act, Cornell-Bechelli said, “The impact has been huge. Just this morning I was at an event, someone was saying that ‘four years ago I would have never even known that I was eligible for Medicaid but because of the Affordable Care Act and because of the expansion, I’m now eligible to get coverage.’ When unfortunately this person had reduction of hours. So it’s been a huge boon here in the state.”
Cornell-Bechelli said that the ACA has not caused a financial strain. Instead it has created an influx of dollars from the federal government. She said that federal funding has helped the state fill some holes that it had before. Cornell-Bechelli said that the governor acknowledged that when he decided to expand Medicaid under the ACA.
Christie has mentioned that he wants to implement a Medicaid per capita cap on spending in order to control cost. Cornell-Bechelli said that would be fairly problematic when it comes to balancing the budget. She said that the state would have to address what to do with the absence of funds.
“We know that the need is out there,” said Cornell-Bechelli. “We see day in and day out people coming and saying to us, ‘This program is saving my life. The expansion has saved my family.’ So I think there’s just going to be more need of people who want it, so removing finances for it will be tough.”
In order to control costs, Christie has proposed withholding $3 billion a year from the state budget. Cornell-Bechelli said that the governor is entitled to his opinions. She said that it’s interesting that the governor was supportive of the expansion and that she is grateful for that, but she’d hate to see that rolled back.
Medicare is turning 50 years old but when it first began, it had been criticized as socialized medicine. In 45 years from now, Obamacare will be turning 50, and Cornell-Bechelli said that history will show that the country needed the ACA.
“I think history will show this country needed this,” she said. “This country wanted it. Sixteen million Americans can’t be wrong in purchasing plans, paying for those plans and then ultimately using them. I think what we’ll also come to find, and we’ve seen this already just in a few short years, the cost savings for everyone, whether you’re on an Affordable Care Act plan or not, is being reduced so that’s huge.”
While super users — people with acute chronic conditions — still exist and are the highest users of health care and emergency departments, Cornell-Bechelli said that one of the initiatives being worked on for super users are projects like affordable care organizations, which would provide preventative services and take cost savings and bring them back into the community.
On what is that biggest challenge to Medicaid right now, Cornell-Bechelli said, “I think super users are a real challenge and that’s why you’ve seen this administration historically take some really hard lines of what we’re going to do to make sure that all of our services are tied to outcomes and not just treating an illness but treating a patient and treating a person. Because when we start to treat people and not just this disease versus that disease, is really where we can start to turn the tide on what these super users are facing and the duplicativeness and increased tests that they might not need. I think we’ve really taken a strong stance on that in a variety of ways nationally and here in New Jersey.”