NJ Assoc. of Health Plans President Optimistic Health Care Reforms Will Be Ready

The Affordable Care Act is gradually getting implemented with Oct. 1 as the beginning of the enrollment period for eligible individuals. New Jersey Association of Health Plans President Ward Sanders sat down with NJ Today Managing Editor Mike Schneider to discuss what New Jerseyans should expect.

Sanders said the health plans that he represents are preparing for federal health care reform. He explained that there are some key elements coming in 2014, the most significant of which being the roll-out of the health care exchanges. “I think there’s a confidence that things will move forward. I think there will be some bumps along the road as implementation rolls out though,” he said.

The readiness of the technology concerns Sanders a bit. “The federal government is going to check your eligibility under the law through these online marketplaces. And some of the technology behind that I think is still being worked out and still being tested,” he said.

Sanders said he believes everyone will work hard to make sure that eligible individuals are able to get coverage and that the roll-out goes as smoothly as possible.

So-called navigators for the Affordable Care Act (ACA) are helping in the outreach to populations that are targeted for eligibility for the subsidy. “I think one of the lessons that we learned in family care as a state when we were building family care, when the state was rolling that out, was that just because you offer subsidized or even free coverage doesn’t necessarily mean that people sign up. So there has to be efforts to go out there and reach out the population,” Sanders said.

Some worry that the roll-out of the ACA will impact workers’ schedules. The Hamilton school district has announced it will not allow substitute teachers to work five days a week to avoid having to provide them health insurance and UPS has announced it will drop health insurance for employees’ spouses who can get coverage through their own employers. While Sanders said it’s not surprising that some employers have made these decisions, he doesn’t believe it will be the norm.

“Most employers I think will continue to offer coverage. New Jersey has a strong employer-based insurance model,” Sanders said. “And so I think there will be some folks, we shouldn’t be surprised by that. To be determined as to how much of that is gonna happen though.”

Sanders said the Record Center for State Health Policy has anticipated about 444,000 additional individuals to get coverage in different markets. “A good chunk of that is going to be in the Medicaid market through the Medicaid expansion, which New Jersey selected to do. And especially around the commercial individual market where the subsidy will be. I think you’ll see less uptick in the small employer and large group markets. I think that the plans are ready,” he said. “This is not the first time we’ve seen significant increases in enrollment. Certainly our Medicaid and family care program in New Jersey has gone through periods where there have been significant increases in enrollment and I do expect that they’ll be able to handle that.”