Governor Signs Gopal Bill Creating State-Based Health Exchange in New Jersey

07/02/19 | News

TRENTON – Acting to improve health care access for New Jersey residents, Governor Phil Murphy last week signed legislation sponsored by Senator Vin Gopal establishing a State-Based Health Exchange in New Jersey. Under this law, New Jersey will have greater control over its health insurance market and the ability to establish stronger protections against the Trump Administration’s sabotage of the Affordable Care Act.

“This new law is an important step forward in making sure that families can access more affordable health coverage,” said Gopal (D-Long Branch). “Right now, the federal government has done serious damage to the national exchanges, cutting enrollment periods, and slashing funding for critical outreach and advertising. By creating new health insurance exchanges based right here in New Jersey, we can keep our local health insurance market stable, protect residents from disruption to their health or insurance, and make sure that we can keep premiums low and coverage high.”

Currently, New Jersey uses the federal exchange, or Marketplace, which provides a platform for consumers to shop for and enroll in coverage. Transitioning to a State-Based Exchange (SBE) will give the state more control over the open enrollment period; access to data that can be used to better regulate the market, conduct targeted outreach and inform policy decisions; and allow user fees to fund exchange operations, consumer assistance, outreach and advertising. By redirecting the assessment on premiums, currently paid to the federal government to utilize a Federally Facilitated Exchange (FFE), New Jersey can operate an exchange that is tailored and efficient for New Jersey residents.

The law provides that the Department of Banking and Insurance shall coordinate the operations of the exchange with the operations of the State Medicaid program and the NJ FamilyCare Program to determine eligibility for the programs as soon as practicable. The Commissioner of Human Services, in consultation with the Commissioner of the Department of Banking and Insurance, shall submit a proposal for available federal financial participation funds to CMS for the Medicaid eligibility platform and the exchange to be integrated.

Under the law, the Commissioner of Banking and Insurance shall establish an advisory committee to provide advice to the commissioner concerning the operation of the exchange. The advisory committee shall include at least nine members, as follows: (1) The Commissioner of Banking and Insurance, or a designee, who shall serve ex-officio; (2) The Commissioner of Human Services, or a designee, who shall serve ex-officio; (3) the Commissioner of Health, or a designee, who shall serve ex-officio; and (4) six public members, who shall be residents of the State, appointed by the Commissioner of Banking and Insurance. Each public member shall have demonstrated experience in one or more of the following areas: health insurance consumer advocacy; individual health insurance coverage; small employer health insurance coverage; health benefits plan marketing; the provision of health care services; or academic or professional research relating to health insurance.