What Repealing Obamacare Could Mean for New Jersey

By Brenda Flanagan

Some 700,000 New Jersey residents like Donna DeStefano feel anxious about their health care. She just enrolled in Obamacare this month, even as the Trump administration moves to repeal it. DeStefano went months without coverage.

“I’m hoping to pay less. I think we all have to wait and see. I just don’t know,” she said.

Donald Trump’s first executive order’s designed to unravel the Affordable Care Act by loosening regulations, even as the Republican Congress works to repeal and replace it. Beyond that, details are scant and Senate Democrats are spooked.

“If they repeal this, we will lose $1 billion. It’ll cost us $1 billion in our state budget,” said Senate President Steve Sweeney.

“How are we going to pay pensions? We still have property taxes that we need to deal with. School funding. Those are three big issues that are themes of our upcoming budget. And to now be hit with perhaps the repeal of the Affordable Care Act will have a devastating impact on the budget of New Jersey,” said Sen. Paul Sarlo.

Lawmakers fear Congress will switch federal Medicaid funding from current unlimited coverage to basic block grants — just a chunk of money for each state to spend. And a Trump spokeswoman this weekend seemed to indicate that’s the plan.

“Block grants Medicaid to the states so people who are closest to those in need, through Medicaid, which guarantees health insurance to the poor — that those who are closest to the people in need will be administering it. You really cut out the fraud, waste and abuse and get the help directly to them,” said Kellyanne Conway.

“New Jersey, here’s your money and good luck with that. Cover those you want to cover, don’t cover those you can’t. And what they’re framing this as is giving states ‘independence.’ Which is code for ‘We really don’t care what you do, what happens to your people, because we’re going to give you a defined bucket of money.’ That’s not independence. It doesn’t give us any real flexibility. We will have to get tighter and smarter, but also crueler if it is that we have to cut enrollees from the program,” said Sen. Joseph Vitale.

“People will get sicker and some people will die. Not to be alarmist about it, but some people will die if they don’t get access to their doctors and medications. It’s a very serious change and a very serious problem for our state,” said Dena Mottola Jaborska, associate director of New Jersey Citizen Action.

Advocates and lawmakers alike will lobby Gov. Chris Christie and New Jersey’s congressional delegation to press Trump not to cut coverage, especially for the chronically ill and poor. Only two health insurers remain in New Jersey, and continued uncertainty could chill the market even further.

“Because they try to predict what the risk is going to be. They don’t know what the risks are going to be, and it does look like they’re not going to support the marketplace like they have in the past. If that’s the case, a lot of insurers are going to have second thoughts about participating,” said Ray Castro, senior policy analyst for New Jersey Policy Perspective.

The Congressional Budget Office says repealing the Affordable Care Act without immediately replacing it could send insurance premiums soaring 25 percent the first year alone. But nobody’s got details or a timeline.