With Congress thus far failing in its multiple attempts to roll back progress on health care by repealing the Affordable Care Act (ACA), President Trump is increasingly taking matters into his own hands. This week his sabotage efforts intensified even as we approach the crucial open enrollment period for 2018 coverage in the federal Marketplace.
The President’s move to end cost-sharing subsidies for insurers will wreak havoc in New Jersey, with premiums likely increasing by 20 to 30 percent in the state.
The change will most harm the 150,000 New Jerseyans who pay the full cost of their insurance, both on and off the federal exchange. It could cause their average annual premium – currently an estimated $5,748 – to increase between $1,100 and $2,200, making insurance unaffordable for thousands. Most New Jerseyans who receive individual subsidies in the exchange (about 200,000 individuals last year) will not be directly affected by this change – at least in the short run.
This is on top of the executive order the President issued Thursday that could destabilize the health insurance markets where millions of individuals and small businesses get their coverage and undermine protections for people with pre-existing health conditions. That policy changes outlined in that order would harm New Jersey more than most other states. (The executive order itself doesn’t change policy, but instead directs agencies to consider making changes by issuing regulations and revising guidance.)
Contrary to President’s claims, these changes would reduce coverage and access while increasing costs. Not only would they eliminate all the federal essential benefits that are currently guaranteed for nearly everyone (like hospitalization, mental health and maternal care) for organizations that form health plan associations, they would allow these businesses to bypass the many additional benefits required under New Jersey law, such as treatment for autism.
Since New Jersey requires more benefits than other states, organizations forming these associations would have more of an incentive to buy cheap policies across state lines. That would have a twofold effect: New Jerseyans who purchase these bare-bones plans will not be adequately covered if they have a real medical emergency, and the state’s entire commercial market would be at risk because the healthiest New Jerseyans could leave the New Jersey marketplace, leaving only the sickest consumers and driving up premiums to unaffordable levels.
At the same time as the President is attempting to dismantle key parts of the ACA via executive order, his administration has slashed federal funding for Navigators. This will gut the entire outreach effort in New Jersey and likely result in thousands of New Jerseyans not receiving the coverage they desperately need. The state’s 62 percent reduction was the largest in the Northeast and the ninth largest nationally. Two of the state’s five navigator contracts were cut by a stunning 85 percent. Most of these agencies will probably have to lay off staff, reduce marketing, help fewer New Jerseyans eligible for Medicaid, or spend less time with consumers who have language barriers or other complex needs.
Despite all the confusion and the political theater surrounding the ACA, New Jerseyans should absolutely still enroll for coverage in 2018. The enrollment period that begins November 1 is crucial, and thanks to the Trump administration, it’s actually shorter this year than in past years – it will end this December 15.
