NJ Left with Three Obamacare Insurance Providers

By Brenda Flanagan

“I can’t afford it,” said Milagros Martinez.

Martinez works temp jobs, part-time. She can’t swing $350-a-month premiums for health insurance through the Affordable Care Act.

“Or else I can’t pay my rent and my bills. So the only thing I could afford is the penalty,” she said.

But while advocates encourage uninsureds like Martinez to shop for ACA insurance — it currently covers about a quarter million New Jerseyans — the options are decreasing. New Jersey Obamacare will lose the second of its five providers Jan. 1 when insurance startup Oscar drops out. Aetna just bailed on plans to join Jersey’s ACA leaving just three remaining Obamacare insurers offering coverage here: AmeriHealth, Horizon and Health Republic.

“It’s definitely a loss for New Jersey consumers,” said Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute.

Schwimmer says insurers here have already filed for modest rate increases, but rising costs keep pushing companies to quit.

“This is not the way it was supposed to be. We’re really at a turning point where both the state and the federal government have to do something. They have to make changes, both to the Affordable Care Act as well as to a lot of laws in New Jersey that impact the cost of health care,” she said.

“It is, I think, a wake-up call that we need to improve the marketplace and we need to improve insurance conditions in New Jersey as well,” said New Jersey Policy Perspective Senior Analyst Ray Castro.

Castro urges lawmakers to look at corralling out-of-network billing and other issues that inflate costs. But a federal study notes even if final rates rise by double digits, more than half of New Jersey consumers should be able to purchase an Obamacare health care plan for $75 a month or less.

“The fact of the matter is, whether it’s five insurers in New Jersey or three insurers in New Jersey, wherever you are in the country, everyone in your communities can buy a plan — the majority of them for less than $75 as today’s brief shows — and issuers are competing based on price, based on the quality of their product, based on the services they provide with in their coverage,” said Ben Wakana, deputy assistant secretary for public affairs for the U.S. Department of Health and Human Services.

Martinez says she’ll look at enrollment prices.

“I work through an agency but they offered and I can’t afford that, either,” she said.

“I think that we do need to lower the premium costs, and there are ways we can do that across federal and state levels, so I think there’s a solution to this problem,” Castro said.

Rates for the next enrollment will be announced in October. Enrollment begins Nov. 1.