TRENTON — State health care organizations, insurers and leaders had mixed reactions to Gov. Chris Christie’s health-spending agendas in a state budget address Tuesday.
Health officials expressed concern about, and in some cases opposition to, Christie’s plea to Horizon Blue Cross Blue Shield of New Jersey to create a permanent fund, with money from its surplus income, to help pay for addiction treatment for vulnerable and underinsured people.
“As the sole insurer with this unique nonprofit status and historically charitable mission, Horizon shares in the financial obligation of caring for our most vulnerable citizens and can set aside in this fund excess surplus monies and other revenue to support our efforts to beat this disease (of addiction),” Christie said.
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Christie said in his speech that Horizon has “over $2.9 billion in surplus on nearly $12 billion a year in revenue” and should use that money to subsidize more health programs and needs, but Horizon officials said that amount is overstated.
Horizon provides health insurance to about 3.8 million people in New Jersey, including 900,000 Medicaid clients.
Horizon officials emphasized the need for a reserve, counted at about $2.4 billion in 2016, to act as a safety net. The money would help pay for sudden drug-price increases, care in natural disasters, public health emergencies or any other unexpected emergencies and expenses.
“Horizon knows well that more is needed to help New Jersey’s most vulnerable and financially challenged residents and agrees with the governor that more should be done,” officials said in a statement. “However, raiding the reserves that protect the families we insure, including our Medicaid members, will only make insurance more expensive and less secure.”
While other state health leaders have agreed with Christie’s focus on addiction treatment and prevention in the past, some were quick to say this solution for more funding was not the answer.
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Wendell Steinhauer, president of the New Jersey Education Association, said the reserves were in place for a reason and dipping into them was likely to cause people’s health care premiums to rise.
“Using the health care reserves of the state’s largest insurer as a stand-in for public health care funding will do little to ensure comprehensive health coverage for the poor in the face of massive federal cuts to funding for (the Affordable Care Act) and Medicaid,” said Maura Collinsgru, an NJ for Health Care organizer.
New Jersey Hospital Association officials have expressed concern about how an Affordable Care Act repeal without immediate replacement would negatively affect hospitals, predicting there would be a shortage of money through charity care to help uninsured people pay for services.
State hospitals use charity care money to treat low-income and underinsured people. Funding has been halved since 2010, but more than 500,000 people got coverage through expansion of the state Medicaid program in 2014.
Christie proposed an additional decrease of $50 million in charity care funding for the 2018 budget.
Betsy Ryan, president and CEO of the New Jersey Hospital Association, said uncertainty for the now-800,000 New Jersey residents who have health insurance under the Affordable Care Act was the prime reason to keep charity care funding until more was known about how people would be covered in the future.
Other items in Christie’s $35.6 billion spending plan for fiscal year 2018 included $30 million toward a graduate medical education program to address doctor and nurse shortages in the state and $200 million in state and federal funds to help disabled adults.
Christie plans to devote $430 million to addiction services. The state budget sets aside money for screening programs, youth in-patient placements, expansions and continuations of the Recovery Dorms, Recovery Coaches and Drug Court programs as well as reopening the Mid-State Correctional Facility as a substance use disorder treatment program site.
Ryan and other leaders agreed on Christie’s agenda to save residents, and thus the state, from additional health care spending by better regulating and reducing out-of-network surprise insurance bills. A bipartisan bill is making its way through the Legislature.