GOP health bill saves tax dollars, but 1M in NJ could lose insurance

July 02--As many as a million New Jerseyans could lose their health insurance under Trumpcare, according to a new report, causing the state's uninsurance rate to more than double within five years.

Younger consumers would get a break, while older consumers not yet eligible for Medicare would pay much more, a separate analysis said.

"New Jersey stands to lose a lot," said Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation, a health care philanthropy group based in Plainsboro.

The reports add more hurdles to the Republican bid to dismantle the Patient Protection and Affordable Care Act, often nicknamed Obamacare, and replace it with a plan that will cost taxpayers less money.

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The GOP in the Senate has struggled so far to find a consensus for its Better Care Reconciliation Act. It prompted President Donald Trump last week to suggest repealing the Affordable Care Act first and replacing it later.

And it shouldn't be a surprise. The nation's $3 trillion health care industry is the rare sector whose stakeholders amount to everybody: seniors and infants, providers and insurers, businesses and unions.

It is an emotional issue. Walter Gersak, 72, lives in Manchester with his wife Eva, 71, and daughter, Emilia, 41, getting by on his Teamsters' pension and Social Security.

Eva suffers from Alzheimer's, and Walter no longer can care for her alone. Emilia decided to leave her job as a nursing assistant to care for her mother full time.

They didn't want to put Eva in a nursing home, fearing her care would suffer. So they have been fighting to get approved for Medicaid, which would at least help pay for home care, they said.

"I've seen a lot of families actually going through the same thing I'm going through right now," Emilia Gersak said.

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New Jersey has nearly 800,000 residents who are covered by aspects of the Affordable Care Act. About 547,000 have insurance through its expansion of Medicaid, and about 250,000 bought insurance through the ACA's marketplace, according to figures from the New Jersey Hospital Association.

It helped New Jersey's uninsurance rate fall from 12 percent in 2013 to 8 percent in 2015, according to Kaiser Family Foundation, a health care research group.

Obamacare had no shortage of complaints, either. Consumers have dug deeper into their own pockets to pay for health care because of higher deductibles. Insurers in New Jersey have tightened their networks, forcing some consumers to find new doctors. And there is a sharp philosophical divide about the role government should play in providing health care.

While New Jersey's two Democratic Senators, Robert Menendez and Cory Booker, have opposed the Republican plan, U.S. Rep. Tom MacArthur, a Republican whose district includes part of Ocean County, has been credited with reviving his party's long-standing goal of ending Obamacare when it appeared to be on thin ice.

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"I am glad to see the Senate further improve (the House health care bill) and put us one step closer to lower premiums, expanded consumer choice and a health care system that protects the most vulnerable," MacArthur said after the Senate introduced details of its bill.

The Senate health bill would reduce the federal budget deficit by $321 billion during the next decade, according to the Congressional Budget Office.

But less money for health insurance programs would mean more uninsured.

A report by the Robert Wood Johnson Foundation and Urban Institute predicts New Jersey's uninsurance rate among non-elderly adults would climb from 8.7 percent to 22.1 percent by 2022.

The reasons:

1. It would eliminate penalties for consumers who aren't covered by health insurance, and it wouldn't mandate that large employers offer workers coverage that meets specific standards, according to the Congressional Budget Office.

2. The bill would reduce federal funding to low-income consumers in New Jersey receiving Medicaid from $12.4 billion to $6.2 billion by 2022, according to the Robert Wood Johnson Foundation and the Urban Institute.

3. The bill would cut tax credits for consumers buying coverage in the Obamacare marketplace from $694 million to $59 million by 2022, the Robert Wood Johnson Foundation and Urban Institute said.

4. Insurers could charge consumers more based on age.

A Kaiser Family Foundation study found: A 27-year-old who makes $50,000 a year paid $3,930 a year for a silver plan under the ACA. That person would pay $3,630 a year under the GOP plan, saving $310.

(They weren't eligible for tax credits in either version of the law).

A 60-year-old who makes $50,000 a year paid $5,100 a year for a silver plan after tax credits under the ACA. They would pay $13,660 a year under the GOP plan. The net result: They would pay $8,560 a year more.

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

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