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Dena Mottola Jaborska
N.J. Citizen Action
75 Raritan Ave., Suite 200
Highland Park, NJ 08904

New Jersey

ImageThe NJ For Health Care Campaign is made up of a broad-based alliance of health care, consumer, senior, student, disability, women's, labor, faith-based, civil rights and social justice organizations working to bring guaranteed, high quality, affordable health care to all New Jersey residents.

We are working to build strong alliances with patients, providers, small and large businesses and health care and social service agencies across the State.

Join Us!

Get involved! Whether you are an individual, organization, or business owner help make guaranteed access to high quality, affordable health care a reality for all New Jerseyans.

On this New Jersey page:

* New Jersey Health Insurance Exchange
* New Report Demonstrates How the Affordable Care Act Will Benefit NJ's Working Families
* New Payment Reform Principles!
* Rally Celebrates & Informs: 6-Month Anniversary of Affordable Care Act
* What Next? Making It Work for New Jersey

* NJ For Health Care Opposes Governor Christie’s Cuts to FamilyCare and Charity Care

* New Jersey's Under 31 Insurance Law
* "New Report Shows How Much New Jersey Families Can Afford to Spend on Health Care"
* "New Report: The Right Rx for NJ — National Health Care Reform"
* "State Practices in Health Coverage for Immigrants: A Report for New Jersey"
* NJ FamilyCare RESTORED in NJ's FY2010 State Budget!
* Recent History: Health Care Reform in New Jersey
* Preventable Medical Errors
* NJ FamilyCare
* Prescription Drugs

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New Jersey Health Insurance Exchange

Health Insurance ExchangeWhat is a Health Insurance Exchange?

The Affordable Care Act (ACA) makes great improvements to access and affordability in our health care system. One major way that the law does this is by establishing new state health insurance exchanges. A health insurance exchange is a virtual marketplace intended to make purchasing health insurance more transparent and affordable for consumers. An ideal health insurance exchange would create competition, transparency and accountability in the insurance market, therefore bringing down the cost of insurance premiums for consumers.

Under the ACA, states are required to establish these state level health insurance exchanges or allow the federal government to establish an exchange for their state. It is also the only provision in the law that requires states to include stakeholders in the planning process. On January 1st, 2013, all 50 states must submit a proposal for their own health insurance exchange to the federal government and by 2014 all exchanges must be implemented. So far New Jersey has received $1 million to begin planning for a New Jersey exchange. The NJ for Health Care Coalition believes that a good exchange must meet the following principles:

Principles for Establishing a Pro-Consumer NJ Health Insurance Exchange

The Patient Protection and Affordable Care Act (ACA) greatly improves access and affordability in our health care system. State health insurance exchanges are a cornerstone of this law, providing a way to promote competition, transparency and accountability in the insurance market and bring down the cost of insurance premiums for consumers.

The new exchange must meet the following principles:

Resources

For more information contact: Jeff Brown at jeff@njcitizenaction.org or 732-246-4772 x14.

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New Report Demonstrates How the Affordable Care Act Will Benefit NJ's Working Families

imageOn March 17, 2011 NJ Citizen Action Education Fund and NJ for Health Care released a new report by New Jersey Policy Perspective, analyzing the impact of the Affordable Care Act (ACA) on New Jersey's struggling working families.

The Report (click here)"Good Medicine: The Impact of the Patient Protection and Affordable Care Act on New Jersey's Working Families with Children" — identifies specific benefits of the ACA and makes recommendations about how New Jersey can maximize its benefit under the new law. Complete details here.

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New Payment Reform Principles!

The passage of the Affordable Care Act creates opportunities for our state and our country to pursue innovative health care payment reform models designed to promote accessible, coordinated, patient-centered care that focuses on health and disease prevention and reduces health care costs. As payment reform models are advanced, a number of critical concerns, particularly for health care consumers, must be addressed by any legislation or other efforts to implement payment reform.

The NJ for Health Care Coalition has adopted the following 12 patient priorities that any payment reform model, including Accountable Care Organizations (ACO) and Medical Homes must incorporate to ensure that the health and rights of consumers are protected.

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Payment Reform: 12 Patient Priorities

Any payment reform model, including Accountable Care Organizations (ACO) and Medical Homes must incorporate the following principles to ensure that the health and rights of consumers are protected.

  1. Transparency: Measures of care and incentives built into the payment system must be open, transparent, and understandable by patients. The legislation should provide for an open process through which there is full disclosure, capacity for public review, and explanation of all payment criteria.

  2. Protect Vulnerable Consumers: Payment policies should take into account the higher costs of patients whose needs are affected by high medical utilization, socio-economic status, language and other social/cultural factors. Patients with high medical utilization should be protected by global payments.

  3. Consumer Voice: There must be a substantial number of consumer representatives on the Board of any Accountable Care Organization (ACO). Any government body that regulates, sets policies, or approves payment plans for ACOs must establish a process in which the public has the opportunity to review and comment.

  4. Savings Shared With Consumers: Any cost savings must be used by the ACO to expand access and improve the quality of services provided in addition to providing savings to taxpayers.

  5. Patient Choice and Care Accessibility: The payment system should ensure patient choice of primary care and other providers such as specialists, nurse practitioners and mental health professionals. Patients must have access to caregivers with linguistic and cultural capacity to provide effective care. Payment systems must promote patients' continuity of care with their providers. Patients must have access to medically necessary out-of-network care.

  6. Improve Quality: Any gain-sharing payments made to an ACO must be based on improved outcomes.

  7. Evaluation and Monitoring: The legislation must include independent, meaningful and frequent monitoring and evaluation of the payment system focusing on quality of care, including outcomes, patient satisfaction and quality of life. The evaluation must be public.

  8. Patient Empowerment: A number of patient activation and patient empowerment methods have been shown to lead to better health outcomes, reduced disparities, and better satisfaction with one's health care, as well as reduced costs. Models such as chronic disease self-management, ideal medical practice, shared decision-making, and others must be supported by the payment system employed by the ACO.

  9. Promote Public and Community Health: Payment reform must be accompanied by a commitment to fund public and community health initiatives. Any ACO must be inclusive of community based providers such as health departments, community health clinics, mental health providers and homeless shelters. New resources must be added to current public health spending for payment reform to be successful.

  10. Patient-Centered Primary Care: Payment reform legislation should align incentives so that patient-centered primary care is the center of our health care system. The payment system should support teams that can deliver culturally-competent, coordinated preventive and primary care that focuses on the patient's physical and behavioral health. The system should encourage development of a robust adequate primary care workforce. Providers must receive on-going training and evaluation to ensure competency and accountability.

  11. Care by Appropriate Providers: Care must be provided by the most appropriate caregiver, practicing within their scope of practice and specialty. Health professionals must have workplace rights, whistleblower protection, and serve on committees developing practice models, reviewing outcomes and care management.

  12. Public Benefit Driven Motives: Any ACO must be a non-profit entity and all employees of the non-profit must have reasonable salaries.

(You can also download these 12 Patient Priorities.)

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Rally Celebrates & Informs: 6-Month Anniversary of Affordable Care Act

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On September 23, 2010, NJ Citizen Action, NJ for Health Care, NJPIRG Student Chapters, and the NJ Main Street Alliance hosted a rally, at Rutgers University in New Brunswick, to celebrate the new benefits of the Affordable Care Act, and help to educate our peers about the new law. It is now six months old and several new provisions officially take effect.

The "R U Insured?" Rally brought together students, health care advocates, small business owners, and seniors to celebrate the Affordable Care Act's six-month anniversary. The focus of the event was on what health care reform means for each of us, and to help spread the word. People shared first-hand stories about how they are benefiting from the new law. Participants also distributed healthcare-themed zines and a new report on the health benefits for young adults to students and faculty.

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What Next? Making It Work for New Jersey

imageA Statewide Health Care Implementation Conference

Thank you for attending the Health Care Implementation Conference on June 8, 2010 and making it a huge success! Special thanks to Community Catalyst, all the panelists, our planning committee, and all the conference participants — your breadth of knowledge, diversity, thoughtful questions, and feedback made this a truly dynamic and substantive event.

Now that we have set the stage for implementation in our state, it is time to roll up our sleeves and get the work done. Please join us in taking the next steps to support implementation by joining our NJ for Health Care Coalition. With your help we can ensure that our state maximizes the benefits available to us through the federal health reform law. Please sign on to the NJ for Health Care coalition to get more involved.

News Coverage: "Young Adults Get Big Benefit Under New Health Care Law" (The Record / NorthJersey.com — June 10, 2010) and "How Controversial Federal Healthcare Law Will Affect Garden State" (NJ Spotlight — June 9, 2010).

Materials from Conference

Download all materials, from all six sections, in a single 4 MB zip file. Also, you can download each individual document below.

Table of Contents

At-A-Glance Agenda: WHAT NEXT? Making it Work for New Jersey, A Statewide Health Care Reform Implementation Conference (download)

SECTION ONE
National Health Care Reform: What does it mean for New Jersey, and what comes next?

  1. Community Catalyst, PPT presentation (June 2010). "National Health Care Reform: What does it mean for New Jersey, and what comes next?" (download)
  2. Community Catalyst (March 2010). "Summary of National Health Care Reform Legislation and Reconciliation Amendment." (download)
  3. The Henry J. Kaiser Family Foundation (April, 2010). "Focus on Health Reform: Health Reform Implementation Timeline." (download)
  4. Community Catalyst (June 2010). What National Health Care Reform Means for New Jersey (download)
  5. Star Ledger (March 2010). "NJ Tea Party Protest on 'unchecked' government, health care bill in New Jersey." (download)
  6. Statehouse Bureau (April 15, 2010). "NJ Tea Party searching for political control, unified message" (download)
  7. Community Catalyst (April 2010). "Quick Wins: Who Will Be Helped Right Away By the New Health Care Reform Law?" (download)
  8. Community Catalyst (May 2010). "Health Care Reform Will Secure Coverage and Improve Quality of Care." (download)

SECTION TWO
Implementing Reform in New Jersey

  1. National Academy for State Health Policy (November 2009). "A State Policymakers' Guide To Federal Health Reform: Part I: Anticipating How Federal Health Reform Will Affect State Roles." (download)
  2. National Academy for State Health Policy (November 2009). "Briefing: Supporting State Policymakers' Implementation of Federal Health Reform." (download)
  3. New Jersey Policy Perspective (February 2010). "Estimated Impact of Health Reform Bills Passed by the House and Senate on New Jersey" (download)
  4. New Jersey for Health Care (May 2010). "Establishing a High Risk Pool for New Jersey" (download)

SECTION THREE
National Health Reform and Cost-Quality: How Can New Jersey Utilize the New Reforms to Move the State Health Care Agenda?

  1. Community Catalyst, PPT presentation (May 2010). "Delivery System Change in Health Reform: Improving Quality, Controlling Costs" (download)
  2. Community Catalyst (2010). "National Health Reform and Cost-Quality: How Can New Jersey Utilize the New Reforms to Move the State Health Care Agenda?" (download)
  3. Community Catalyst (2010). "Campaign for Better Care Overview" (download)
  4. Dr. Brenner, Power Point Presentation (June 2010) on Camden ACO project (download)
  5. John Jacobi, Power Point Presentation (June 2010) on Cost, Quality, and Consumer Benefit (download)

SECTION FOUR
Promoting Health Equity Through Health Care Reform

  1. Community Catalyst, PPT presentation (June 2010). "National Health Reform and Reducing Health Disparities in New Jersey" (download)
  2. Community Catalyst (March 2010). "Community Benefits: Protect Consumers and Strengthen Dialogue between Hospitals and Communities" (download)
  3. Community Catalyst (March 2010). "Protect and Target Federal Funding for Safety Net Hospitals" (download)
  4. Community Catalyst (March 2010). "Improving the Health of our Communities: Promote the Availability of Healthy Food in All Neighborhoods" (download)
  5. Community Catalyst (March 2010). "Using Data to Track and Reduce Health Disparities in Medicaid" (download)
  6. Community Catalyst (March 2010). "Promoting Cultural Awareness and Language Assistance in Health Care" (download)
  7. National Immigration Law Center (April 2010). "How Are Immigrants Included in Health Reform?" (download)

SECTION FIVE
Communicating the Patient Protection and Affordable Care Act to the Public

  1. Herndon Alliance, PPT presentation (June 2010). "Implementing Health Reform: Context and Climate." (download)

SECTION SIX
Additional Resources

  1. Community Catalyst (January 2010). "Building on the foundation: Consumer Advocacy's role in Successful Health Care Reform." Executive Summary (download)
  2. Trust for America's Health. "Patient Protection and Affordable Care Act (HR 3590) Selected Prevention, Public Health & Workforce Provisions." (download)
  3. U.S. Department of Health & Human Services (2010). "Young Adults and The Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Businesses and Families." (download)
  4. Community Catalyst - New England Alliance for Children's Health (April 2010). "Overview of Children's Provision in National Health Reform." (download)
  5. National Academy for State Health Policy (April 2010). "Briefing: Long Term Services and Supports and Chronic Care Coordination: Policy Advances Enacted by the Patient Protection and Affordable Care Act." (download)

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NJ For Health Care Opposes Governor Christie's Cuts to FamilyCare and Charity Care

ImageOn Monday, March 8, 2010, members of the NJ For Health Care Coalition were joined by State Senator Loretta Weinberg (D-37), Chair of the NJ Senate Health, Human Services and Senior Citizens Committee and State Senator Joseph Vitale (D-19), Vice Chair of the NJ Senate Health, Human Services and Senior Citizens Committee at a Statehouse Press Conference to call on NJ Governor Chris Christie to stop cuts to NJ's FamilyCare and Charity Care programs which he enacted through Executive Order.

In addition to speakers from NJ Citizen Action, NJ Policy Perspective, the NJ Primary Care Association, the NJ Immigration Policy Network, and the Middlesex County Advocates, partners including the Health Professionals and Allied Employees, the Association for Children of NJ, AARP NJ, Legal Services of NJ, the Association for the Betterment of Citizens with Disabilities, and the NJ Catholic Conference attended the event.

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New Jersey's Under 31 Insurance Law

ImageThe Patient Protection and Affordable Health Care Act allows young adults to obtain health coverage through their parents' insurance plan up to age 26. However, in NJ young adults can stay on their parents' insurance policies up to the age of 31 if they meet the flowing criteria.

Your Plan:

A Parent:

If the parent's employer offers coverage subject to the law, then the young adult's parent:

A Young Adult:

If both the employer's plan and the young adult's parent meet the above requirements, the young adult may enroll if he or she:

For a more information on the NJ Law visit the NJ Department of Banking and Insurance website.

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New Report Shows How Much New Jersey Families Can Afford to Spend on Health Care

reportA new report by the NJ Consumer Voices for Coverage Leadership Team shows how much money New Jersey families can afford to spend on health care. New Jersey Consumer Voices for Coverage launched Making Health Care Affordable for New Jersey: Real Families, Real Stories to educate New Jersey residents, through community-based organizations, about the health reform debate going on around them, and to take a practical look at what families can, or cannot, afford to pay for their health care.

The aim of this project is to aid policymakers in understanding how much real families living in New Jersey can afford to spend on health care, based on real stories and household budgets of people living across the State. The stories and data presented in this report come from 648 families who attended over 40 community-based workshops throughout New Jersey. Their stories present numerous policy implications on the need to develop a reasonable standard of affordability for New Jersey families if health reform is going to succeed in reducing the number of New Jersey's uninsured.

Key Findings

Policy Recommendations

  1. Develop and implement a sliding scale affordability measure based on income to ensure that New Jersey families are not required to pay more for health care than they can afford.
  2. The affordability scale should provide full subsidies to cover the entire cost of health care for families up to 200% FPL and sliding scale subsides for families at least up to 399% FPL.
  3. New Jersey must collect more data to determine how much families above 400% FPL can afford to spend on health care.

Resources

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"New Report: The Right Rx for NJ — National Health Care Reform" by Ray Castro, Senior Policy Analyst at NJ Policy Perspective

imageOn October 8, 2009 members of the NJ For Health Care Coalition released a new report by NJ Policy Perspective that shows the impact of the health care bill currently in the US House of Representatives on New Jersey's public health and economy.

The report analyzes the major provisions in "America's Affordable Health Choices Act of 2009" (HR 3200) and describes how the bill will benefit New Jersey residents including low and middle income families, small businesses, children, adults, seniors, people with disabilities, and the uninsured. It is the first and only comprehensive analysis examining the impact of HR 3200 on New Jerseyans to date. New Jersey Policy Perspective has also broken down the information by county and Congressional District.

 Photos from the "The Right Rx for NJ" Press Conference

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Ray Castro, Senior Policy Analyst at NJ Policy Perspective and author of the report explains the findings. Reverend Bruce Davidson, Director of the Lutheran Office of Governmental Ministry of NJ. Kelly Conklin, Small Business Owner in Bloomfield, NJ and Spokesperson for the NJ Main Street Alliance discusses the need to reform health care from a small business perspective.

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"State Practices in Health Coverage for Immigrants: A Report for New Jersey" — Rutgers Center for State Health Policy

ImageOn June 9, 2009 the NJ for Health Care Campaign held a TelePress Conference to release a new report by the Rutgers Center for State Health Policy (CHSP) titled "State Practices in Health Coverage for Immigrants: A Report for New Jersey" (June 2009).

Based on key findings in the Report, NJ For Health Care called on State policymakers to restore $1 million for outreach and enrollment funding for NJ FamilyCare in NJ's Fiscal Year 2010 State Budget and recommend that NJ implement more effective outreach and enrollment strategies based on successful practices in states such as New York and Massachusetts including more partnerships with local and community-based organizations, more investment of meaningful financial resources, and the creation of user-friendly one-stop website.

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Funding for NJ FamilyCare RESTORED in NJ's FY2010 State Budget!

ImageGovernor Corzine announced, on June 29, 2009, that the proposed $9 million cut to NJ FamilyCare (which would have cut back enrollment for parents between 150% — 200% of poverty) has been restored. This news is a direct result of the amazing work of the NJ For Health Care Coalition. Not only did we stop the proposed cutback to FamilyCare, but the program has been improved with the elimination of premiums for all children below 200% of poverty.

A special thanks to our partners and allies at AARP, NJ Policy Perspective, NJ Catholic Conference, the Lutheran Office of Governmental Ministry of NJ, Association for Children of NJ, and Legal Services of NJ for working to maintain and preserve access to affordable health care for low and moderate income NJ families.

We also thank Senator Vitale for his strong and outspoken support, Assemblyman Greenwald, Governor Corzine and Members of the Legislature who helped make this critical restoration possible.

Statehouse Press Conference on NJ's Fiscal Year 2010 State Budget

ImageOn May 6, 2009 health care advocates held a Press Conference at the Trenton Statehouse to call on NJ policymakers to OPPOSE proposals in the State's Fiscal Year 2010 Budget to roll back enrollment of parents between 150% - 200% of poverty in the NJ FamilyCare Program, and to implement co-payments for Medicaid recipients and people in the AIDS Drug Distribution Program (ADDP).

The NJ For Health Care Coalition and NJ Coalition For A Moral Budget were joined by NJ State Senator Joseph Vitale (D-Middlesex), Chair of the NJ Senate Health, Human Services and Senior Citizens Committee. Read the letters to the NJ Senate and the Assembly.

With record high unemployment, thousands of New Jersey residents are losing their jobs and health care for themselves and their families. In December 2008 and January 2009 alone, it is estimated that 650 New Jersey residents a day lost their health coverage. Given the current economic climate, it is absolutely the wrong time to freeze enrollment in NJ FamilyCare for low income working parents or implement co-payments for those who can least afford them.

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Recent History: Health Care Reform in New Jersey

NJIn June 2008 the NJ Legislature passed S-1557/A-2624, a health care reform bill sponsored by State Senator Joseph Vitale (D-Middlesex). The bill was signed into law by Governor Corzine in July 2008. The bill expands the NJ FamilyCare Program, allowing NJ to reinstitute enrolling parents up to 200% of poverty. The bill also contains a KidsFirst mandate requiring that all children (18-years and younger) have health insurance. Additionally, there are a number of market reforms in the bill including the introduction of age as a rating factor in NJ's individual insurance market.

State law now requires that all children (18 years and younger) in New Jersey have health insurance as of July 2009. Learn about the options available for your family:

* Click here for more information on Senator Vitale's health care proposal for New Jersey.

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Preventable Medical Errors

ImageNJ Makes Great Strides in Disclosure of Medical Errors!

Nearly 100,000 Americans die each year from Preventable Medical Errors. Preventable Medical Errors (PMEs) are avoidable mistakes that result in serious injury or even death. Many New Jerseyans have experienced the terrible effects of preventable medical errors.

In August 2009, Governor Corzine signed the Hospital Errors Accountability Law (HEAL). After a two year campaign by consumer groups such as AARP, NJ Citizen Action and HPAE, working with Department of Health and Senior Services Commissioner Heather Howard, this health care quality bill became law.

The HEAL bill will improve patient safety in our hospitals by public reporting established patient safety indicators and by implementing payment policies that make patient safety a priority.

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NJ FamilyCare

ImageGo to www.njfamilycare.org to learn about the NJ FamilyCare Program including what it is, who is covered, and what it costs. There you can also download an application or apply online.

On September 14, 2009, NJ Governor Jon Corzine Announces Over 11% Decrease in New Jerseyans without Health Insurance. Read the Press Release.

Background:

ImageThe State Children's Health Insurance Program (SCHIP), enacted with bi-partisan support a decade ago as part of the Balanced Budget Act of 1997 (BBA), is designed to build on Medicaid by providing insurance to low-income children who are uninsured, but ineligible for Medicaid. New Jersey's SCHIP program is called NJ FamilyCare. Click here for more information about NJ FamilyCare and SCHIP.

ResourcesNews Coverage:

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Prescription Drugs

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The NJ Prescription Drug Price Registry

For English: https://www6.state.nj.us/LPSCA_DRUG/index.jsp
Para Español: http://www.nj.gov/lps/ca/espanol/spnjpdr/drugs/
Call toll-free 1-800-242-5846 for help in English or in Spanish

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updated february 28, 2013