NJ Department of Banking and Insurance Warns of Congressional Reconciliation Bill Package’s Impact on Health Insurance Access
TRENTON — New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman has sent a letter to New Jersey’s Congressional delegation warning them of the devastating impacts of the reconciliation package on access to quality, affordable health coverage for millions of Americans who need it, including over 513,000 New Jerseyans. The letter follows the U.S. House passage of the reconciliation package on May 22. A version of the bill is currently pending before the U.S. Senate.
The bill package would repeal key provisions of the Affordable Care Act, making it more difficult and expensive to enroll in coverage through Get Covered New Jersey, the State’s Official Health Insurance Marketplace. This legislation would:
If this happens, it would mean the ACA exchange market would drop by more than 1/3 from the ~24.2 million currently enrolled (myself & my own family included).
However, I've repeatedly stated that even this is likely a low estimate--the remaining ~16 million exchange enrollees would still be hit with MASSIVE (and in some cases eye-poppingly huge) premium hikes which would force them to drop to far worse plans (meaning much higher deductibles & co-pays; worse provider networks and so on).
Last month, in response to House Republicans passing their version of the budget resolution bill, I broke out total enrollment in Medicaid via ACA expansion, ACA exchange Qualified Health Plan (QHP) enrollment and ACA-based Basic Health Plan (BHP) enrollment by Congressional District in order to try and get a sense of just how many Americans healthcare coverage is at risk from the bill...and how that breaks out along partisan lines at the House District level.
As I noted at the time, Republicans seem to be under the impression that it will mostly be Democrats who get screwed by their bill, since 9 of the 10 non-expansion states are Republican strongholds...while some Democrats seem to be under the impression that it will mostly be rural MAGA republicans who get screwed.
Senate GOP tax bill would hit politically explosive Medicaid provision
The Finance Committee is due to brief members on its megabill draft text Monday night.
Senate Republicans are seeking to ratchet up savings from a politically explosive policy within Medicaid to pay for their megabill, and it’s already setting off shockwaves through Capitol Hill.
The Senate Finance Committee’s forthcoming portion of the party-line tax and spending package would lower the Medicaid provider tax to 3.5 percent, according to three people with direct knowledge of the legislation who were granted anonymity to discuss it.
16 Million Americans Would Become Uninsured Due to Reconciliation Bill and Loss of Tax Credits; 8.2 Million in Marketplaces Alone
Leaders from State-based Health Insurance Marketplaces, Enrollees, Providers, and Small Business Highlight Potential, Devastating Impacts
(Washington, DC) The Congressional Reconciliation bill and loss of federal tax credits would result in 16 million Americans losing health coverage, including 8.2 million enrolled in Health Insurance Marketplaces. By stripping millions of lives from the Marketplaces, health care will be more expensive, harder to access, create a strain on health care systems, and hurt small businesses.
There was a lot to unpack there, all of it pretty horrible...but I felt one provision in particular was worth its own separate post:
Funding Cost-Sharing Reductions.
Enacting section 44202 would affect the cost-sharing reductions that the ACA requires insurers to offer to eligible people who purchase silver plans through the marketplaces. Those reductions increase the actuarial value—the average share of covered medical expenses paid by the insurer—above the amount in other silver plans, resulting in lower out-of-pocket costs for eligible enrollees. To be eligible for cost-sharing reductions an enrollee’s income must generally fall between 100 percent and 250 percent of the FPL; the subsidy varies with income.
The Congressional Budget Office has published several projections about how many people would lose healthcare coverage and/or become uninsured (these aren't the same thing) under various versions of the #OneBigUglyBill Act passed by House Republicans, which is currently beginning its next phase over on the Senate side of the Capitol.
Their most recent projection put the total at around 11.7 million when you include some technical weirdness which I'm a little vague about...plus another 3.8 million if you include their projection from December 2024 regarding the impact of the upgraded ACA subsidies included in the Inflation Reduction Act being allowed to expire at the end of this year. This placed the grand total at around 15.5 million...except they more recently sent a letter to the House Energy & Commerce Committee which bumped this estimate up a bit more, putting the combined total at 15.9 million.
Congress Urged to Renew Expiring Enhanced Premium Tax Credits and Prevent Unnecessary Increases in Health Care Costs for New Jersey Residents
Over 450,000 Get Covered New Jersey enrollees would be impacted by loss of expanded financial help
New Jerseyans could lose more than half a billion dollars in federal support and face higher health insurance costs
TRENTON — Warning about significant health insurance premium increases for over 450,000 New Jerseyans, New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman sent a letter to New Jersey’s Congressional delegation strongly urging them to extend the expiring federal enhanced premium tax credits that have enabled hundreds of thousands of New Jersey residents to enroll in quality, affordable health insurance through Get Covered New Jersey, the State’s Official Health Insurance Marketplace.
Rep. Boyle: The one thing I would point out, though, is this bill is actually significantly worse [than the GOP's ACA repeal attempt in 2017], because this piece of legislation will throw 13.5 million, almost 14 million Americans off their healthcare.
First, you're cutting people off Medicaid. But second, this does include very deep cuts to Obamacare as well. And finally, I have breaking news for you tonight, that literally just came out in the last few minutes as I've been sitting here: The nonpartisan Congressional Budget Office, the official authority on these figures, has now confirmed that this bill, in addition to Medicaid cuts, in addition to Obamacare cuts, includes $500 BILLION WORTH OF CUTS TO MEDICARE that is now in this bill as well.
With potential Federal cuts to Medicaid on the horizon, renewing enhanced premium tax credits to ensure affordable insurance through the marketplace takes on greater significance
AUGUSTA— The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) today announced its support for renewing the enhanced premium tax credits for consumers of the health insurance marketplace.
The enhanced premium tax credits, which were first implemented in 2021 through the American Rescue Act and extended in the Inflation Reduction Act are set to expire at the end of this year unless Congress acts. Allowing these federal tax credits to expire will result in higher health insurance premiums for Maine consumers, potentially putting health coverage out of reach for thousands of Mainers. Overall, the enhanced tax credits are saving Mainers a conservative estimate of nearly $90 million in health care premium savings this year.