NJ Dept. of Health Upbeat at Budget Hearing Despite Obamacare Uncertainty

By Briana Vannozzi

With a $1.6 billion slice of the state budget, the head of New Jersey’s Department of Health had mostly upbeat news for the Senate Budget Committee today — a somewhat rare occurrence during these annual hearings.

“We continue to invest in our health care system by expanding health information exchange and increasing quality, access and safety,” said New Jersey Department of Health Commissioner Cathleen Bennett.

But portions of the budget face uncertainty as the fate of the federal Affordable Care Act hangs in the balance. Just this week, Republican congressional members announced they plan to revive their Obamacare repeal. New Jersey’s own federal representative, Tom MacArthur, is leading the push to revamp the law even as state lawmakers grapple with doling out funds.

“If the Affordable Care Act is repealed, will it have a devastating impact on our charity care numbers, number one? And I know we don’t know what Congress may do, but I think we need to know that,” said Sen. Paul Sarlo, chair of the committee.

“We, just like yourselves, can’t really speculate what the impact of any health reforms would be,” Bennett said.

Charity care provides low-income patients without health insurance coverage to receive hospital care at zero or reduced costs. Funding reached its peak in fiscal year 2010, at just over $1 billion. This year’s budget is down to almost a quarter of that.

Funding dropped from just under $480 million in fiscal year 2015 to $252 million for the FY 2018 budget. But New Jersey’s Medicaid expansion as part of the Affordable Care Act had a lot to do with that, enrolling some 500,000 residents for coverage.

“It’s not just less people showing up in the emergency room without insurance, the uninsured. It’s also you have a new payer mix, a stable payer mix through the Medicaid expansion. So it’s a combination of the two that has helped improve the fiscal health of our hospitals. Is that correct?” asked Sarlo.

Bennett said, “That is correct.”

State legislators worry without an ACA backup plan, New Jersey could be left up a creek without, well, you know.

“If for some reason those funds aren’t there, is it anticipated that we would, people would access care through charity care? I know it’s a hypothetical, but we can’t not have a second plan,” said Sen. Jennifer Beck.

“The department has and has always been focused on ensuring that we have care for the uninsured and the under insured. We do it through a variety of methods. Whether it’s our Federally Qualified Health Centers where we reimburse them for each visit for $101, whether it’s expanding the types of primary and preventative care that’s available at FQHCs,” Bennett said.

Beck perked ears when she raised the flag on New Jersey’s rising STD rates.

“From 2009 through 2014, which is the last year of complete data, we’ve seen a 12.1 percent increase in prevalence, but despite that, what we’ve seen is that New Jersey also has less incidence of STDs than what other states in the nation are seeing,” Bennett said.

Groups like Planned Parenthood say restoring funding for family planning services would help.

Late today the committee questioned the commissioner for the Division of Banking and Insurance on Gov. Chris Christie’s proposal to tap Horizon‘s surplus funds. They asked if it was a worthwhile conversation or if the money should go back to ratepayers. But the commissioner wouldn’t take the bait.