NJ Health Insurance Marketplace Readies for October 1 Open Enrollment Start

Health Insurance - words

In a few weeks, in accordance with the Affordable Care Act (ACA), New Jersey residents not covered by employer-sponsored health insurance can begin choosing from an array of (possibly? probably?) more affordable health insurance options, when the state’s Health Exchange Marketplace officially begins operating.

Concerns about a bumpy road and obstacles leading up to and after the roll-out on October 1 (when residents can begin signing up for new coverage), the state legislature has created a 12-member task force to oversee how the NJ marketplace operates in New Jersey.

Meanwhile, officials like U.S. Health and Human Services Secretary Kathleen Sebelius, and advocacy groups are calling for more state cooperation in disseminating easy-to-understand information so residents know about the new plans, and the increased Medicaid coverage that is also part of the ACA.

“We were never going to make this program work from Washington,” she has said. “This has to be an on-the-ground effort.” Rite-Aid, for example, will have informed representatives in several thousand stores on October 1 to help educate citizens, and local representatives from Enroll America have been ringing doorbells around the state to spread the word.

Under the ACA (often referred to as “Obamacare”), every state must have a way for individuals and small businesses who are without coverage, to identify affordable options, purchase a policy, and find subsidies and other assistance programs. Here in New Jersey, Governor Chris Christie vetoed using state funds to operate an Exchange, which meant the state would fall under the law’s fallback option of using federal funds and manpower to set up and implement one. But getting the word out presented difficulties, especially when it comes to eligibility for insurance plans and new Medicaid rules.

According to NJSpotlight, “The income cutoff for Medicaid is being raised from roughly 24 percent of the federal poverty line to 138 percent of the poverty line. The new limit currently amounts to $15,856 for single residents and $32,499 for a family of four.” In addition, “People with income between those levels and 400 percent of the poverty line – which is currently $45,960 for single residents and $94,200 for a family of four — will be eligible for federal subsidies to buy insurance through the marketplace.”

In most cases in New Jersey, coverage for children will be extended to age 26, pre-existing conditions will no longer be allowed in denying coverage, lifetime dollar limits will cease, and many preventive services can no longer carry deductibles and/or co-pays.

Some estimates have said that as many as one million people in New Jersey may be eligible for one or the other program. In 2014, health insurance will be mandatory, with graduated fines imposed on those without it. To see your options, begin at HealthCare.gov for general information. From there, click on Health Insurance Marketplace, then scroll down, select New Jersey and begin by setting up an account (which we hope gets easier than when a reporter recently tried it.)

Open enrollment begins October 1, and continues (for the first year only) until March 31, 2014. Coverage can begin as early as January 1 for most plans.

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