Can NJ Gov. Phil Murphy save Obamacare? Three steps he is taking

March 20--PERTH AMBOY -- Among the steps is reinstating the mandate requiring nearly every consumer have health insurance or pay a penalty.

"In New Jersey, we're trying to address (the GOP's opposition to the health care law) in any way we can," state Sen. Joseph Vitale, D-Middlesex, said.

Vitale spoke Monday at Raritan Bay Medical Center with panelists that included U.S. Rep. Frank Pallone; Murphy's Health Commissioner, Dr. Shereef Elnahal; and Robert Garrett and John Lloyd, the co-CEOs from Hackensack Meridian Health, which owns Raritan Bay. Watch the video above to hear Elnahal discuss the impact of the Trump administration on Obamacare.

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The Trump administration's bid to chip away at Obamacare could bring financial relief to consumers who don't need health care. But it also could lead to sharply higher premiums both for consumers who are covered and for taxpayers who provide subsidies that offset the cost.

Premiums in New Jersey are expected to increase up to 32 percent next year -- and 90 percent over the next three years -- because of uncertainty in the insurance market, according to a report released by California's insurance marketplace.

That would be on top of the 22 percent average premium hike New Jerseyans saw this year.

Lawmakers continue to battle over the Affordable Care Act, the 2010 law that was designed to lower the rate of those without insurance and slow down the skyrocketing cost of health care.

The law set out to cover consumers who weren't covered by Medicare, Medicaid or their employer by:

* Mandating nearly all Americans have insurance or pay a penalty.

* Expanding Medicaid to more low-income consumers.

* Offering tax credits to more consumers to help them afford their plans.

But it did little to quell complaints. Many consumers were forced to dig deep into their own pockets because their insurance plans came with high deductibles. Other consumers, whose incomes were too high to qualify for subsidies, decided to forgo health insurance and paid the penalty instead.

"A typical four-person family in New Jersey without subsidies pays $23,000 a year," said Ray Castro, director of health policy for New Jersey Policy Perspective, a left-leaning research group.

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Pallone said his bill would expand subsidies to consumers in higher income groups. It isn't clear how he plans to pay for it. But with President Donald Trump and the Republican-led Congress in charge, the bill faces a difficult path. Republicans have called for more choice, allowing consumers to buy less expensive plans, even if they don't provide comprehensive coverage.

More likely are steps underway in New Jersey.

1. Restore the mandate

The New Jersey Legislature is considering a bill that would bring back the mandate, requiring most New Jerseyans to have health insurance or pay a penalty -- either 2.5 percent of their household income or $695 per adult and $347.50 per child, whichever is greater.

The provision, among the least popular in the bill, will be repealed beginning in 2019 as part of the tax law that was signed by Trump in December.

But health care experts say the mandate helped stabilize premiums. Without it, they worry that young, healthy people will drop out, forcing an older, less healthy population foot a bill that will become more unaffordable.

"Health insurance works when everyone is in," Vitale, one of the bill's sponsors, said.

2. Insure the insurers

New Jersey lawmakers are considering another bill that would create a reinsurance program. The state would assess health insurers a fee, which would be used to reimburse insurers in the individual market with high-cost customers.

New Jersey needs to receive a waiver from the federal government.

The California study found a reinsurance program could help reduce premiums by more than 10 percent.

3. Get the word out

The Trump administration reduced the enrollment period for consumers to sign up for Obamacare plans for 2018 by six weeks. And it reduced the marketing budget 90 percent.

Castro from New Jersey Policy Perspective said that's one reason New Jersey saw its enrollment in Obamacare plans decline by 20,000. And he has projected New Jersey could have 300,000 more uninsured consumers by 2027.

State Health Commissioner Shereef Elnahal said the Murphy administration plans to reverse that trend. Murphy signed an executive order asking each state department to market Obamacare's open enrollment period.

"He's really asked the whole government to step up," Elnahal said.

Michael L. Diamond; @mdiamondapp; 732-643-4038; mdiamond@gannettnj.com

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