State Expansions: New Jersey
Governor Corzine signed into law a significant health reform bill on July 8, 2008. The new law builds on New Jersey's strong foundation of public programs and private market regulation. Health reform has been a high priority in New Jersey, fueled in part by the efforts of state Senator Joseph Vitale and other health care leaders in the statehouse. These efforts are described in New Jersey's Path toward Universal Coverage (Families USA, May 2007). The new health reform law does the following:
- Mandates coverage for all kids under age 19 as of July 8, 2009. Families must obtain coverage for their children via Medicaid, FamilyCare (New Jersey's CHIP program), or through a buy-in program called New Jersey FamilyCare Advantage for families earning more than 350 percent of poverty ($61,600 for a family of three in 2008). They may also obtain coverage on the individual market or through job-based coverage.
- Expands FamilyCare eligibility to parents earning less than 200 percent of poverty ($35,200 for a family of three in 2008), effective July 2008.
- Improves outreach and enrollment for Medicaid and FamilyCare in order to get all eligible New Jerseyites into subsidized coverage and optimize federal matching funds.
- Increases the minimum medical loss ratio—the percentage of premiums insurers must use to pay for medical services—from 75 percent to 80 percent for both small business and individual carriers.
- Alters individual market premium rate-setting rules. Previously, New Jersey used pure community rating, meaning that insurance companies could not vary premiums based on age or health. The law moves New Jersey to a modified community rating system. Now, the rate for the highest-rated individual may be up to 350 percent of the rate for the lowest-rated individual, based solely on age.
- Clarifies a recent bill that expanded dependent coverage to young adults. Young adults are now allowed to retain dependent coverage from their families until the age of 31 as long as they elect coverage before they turn 30.
For more information, please see the bill statement, or read the full bill.
New Jersey Expansion Resources
For general resources on state expansions, see Other Resources.
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