Health Care

Next month, New Jersey will start reaping the benefits of a bill enacted earlier this year to establish its own health insurance exchange rather than continuing to rely on the federal one.

Lilo Stainton of New Jersey Spotlight reported on October 9 that the Trump administration has given the necessary approval for the state to take its first step in transitioning to a fully state-run exchange by 2021.

As a result, during this fall’s enrollment period, from November 1 through December 15, health plans for 2020 will still be sold through the federal healthcare.gov website but New Jersey will have more control over the process and has committed to spending much more than last year on public outreach and assistance with enrollment.

Read the New Jersey Spotlight article here.

Efforts by the Trump Administration and the GOP majority in Washington to undermine the Affordable Care Act (ACA), aka “Obamacare,” are, unfortunately, having an impact that is driving down the number of people with individual health insurance policies in New Jersey.

According to a June 20 press release from the NJ Department of Banking & Insurance, health insurance enrollment was down more than 10 per cent for the first quarter of 2018, compared to a year earlier. The total number of state residents signed up for individual (non-employer, non-government) health plans was 328,761, down from 368,619 for the first quarter of 2017.

In other words, almost 40,000 fewer people have health coverage. Continue reading ACA ENROLLMENT FALLS IN NEW JERSEY, NEW LAWS SHOULD HELP

Governor Phil Murphy today signed into law landmark legislation that will help keep health care affordable for New Jersey residents by protecting them from surprise medical bills for out-of-network health care.

At least with state-regulated health insurance  plans covered by the plan, consumers will no longer have to pay any more than they would for in-network care unless they are informed of those added costs in advance and consent to pay them.  And added out-of-network charges could never be imposed for receiving needed medical care in an emergency situation. Consumers would remain free to obtain care from out-of-network providers but those bills would no longer come as a surprise.

Other insurance plans that fall under federal law and are thus not subject to regulation by the state, will be able to opt into the law, which takes effect 90 days from today.

The legislation, A-2039, is known as the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act, and the name aptly describes what it does.

For more detail, read my earlier blog posts.  HERE and HERE.

Continue reading MURPHY SIGNS LAW TO END SURPRISE MEDICAL BILLS

A bill that will protect consumers from surprise medical bills took a crucial step toward passage on April 5 when it won narrow approval from the Senate Commerce Committee, by a 3-2 vote.

That same day, S-485/A-2039, also known as the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act, also made it past the Senate Budget Committee (7-3) and the Assembly Appropriations Committee (7-2).

The Senate Commerce vote was regarded as the most uncertain of the three because earlier versions of the bill had stalled in that committee in the prior two legislative sessions.

The bill had already been reported out of the Assembly Financial Institutions and Insurance Committee on March 5, so it is now cleared for votes in both houses.

It is posted for an Assembly floor vote this coming Thursday, April 12, and it is hoped that when the list of bills is posted for the full Senate session that same day, it will also be listed there.

The legislation, most centrally, holds consumers harmless from having to pay more than the in-network rate when they receive services from an out-of-network health provider in an emergency situation or through inadvertence. For non-emergency care, consumers need not pay higher out-of-network rates unless they are informed in advance of the provider’s out-of-network status and what that provider will charge and they agree to those services and charges.

Continue reading MAJOR STEP FORWARD IN EFFORT TO END SURPRISE MEDICAL BILLS

For almost 10 years now, New Jersey lawmakers have been grappling with the issue of what to do about surprise medical bills.

They are the invoices sent by doctors and other health care providers who are not part of your insurance company’s network. So when your insurance does not cover the full amount of what they charge for their services, they come after you to pay the difference. Hence the term “balance billing.”

Continue reading TIME TO PROTECT CONSUMERS FROM SURPRISE MEDICAL BILLS