Nearly 300K in N.J. could lose Medicaid coverage as pandemic emergency ends

Jan 05, 2024

When the pandemic shuttered workplaces and sent unemployment claims skyrocketing, hundreds of thousands of New Jerseyans flocked to Medicaid, the government-funded health insurance program for the poor.

Medicaid enrollment has since swelled to 2.25 million, with 570,000 people joining the rolls from February 2020 to February 2023, according to state data. Nearly one in four residents get their health insurance through Medicaid, also known as NJ FamilyCare.

And they were welcomed. The federal government substantially increased the reimbursements for doctors, hospitals and other medical providers everywhere while requiring states to delay the annual review process determining whether enrollees met the income limits to remain covered. There have been no income verifications in three years.

But very soon, that grace period will end. Beginning in April, New Jersey — like every other state in the country — must verify whether all Medicaid recipients remain eligible. The massive undertaking — ominously called "the unwinding" — is expected to eliminate 5.3 million to 14.2 million people from the 91 million on the Medicaid rolls when it is done 14 months from now, according to Kaiser Family Foundation estimates.

About 293,000 New Jersey residents, 13% of the caseload, are expected to be among those who lose Medicaid coverage, according to state Human Services officials.

Some people will not be affected by the loss because they’ve already landed a job with health benefits. Others will make too much to be eligible for FamilyCare coverage.

But many others will remain eligible and lose coverage anyway because they did not respond to mailings from the state Department of Human Services or their county boards of social services, urging them to provide proof of their income and family size. Some might never get those packets of information because they moved and did not inform the program of their new address.

State Human Services officials say they cannot stress enough how important it is for Medicaid recipients to keep an eye out for these renewal packets in the mail. If people are unsure whether the state has their current address, call the NJ FamilyCare help line at 1-800-701-0710 and provide it.

"Please open that mail and act on it," said Assistant Human Services Commissioner Jennifer Langer Jacobs, who oversees NJ FamilyCare. "Everyone will get a mailing and many members will receive an invite to do renewal online, a new feature since the pandemic."

"We are hearing significant concerns already from our advocacy community and have been working very closely with them throughout the pandemic to be as transparent and collaborative as possible. As they have been talking to us, we have been anticipating everything that could possibly go wrong," Langer Jacobs said.

"We were ready a year ago and we are more ready now," she added.

The unwinding begins even before the Biden Administration officially ends the national public health emergency on May 11. The Consolidated Appropriations Act approved by Congress and signed into law in December required the continuous enrollment provision to end on March 31. The enhanced federal Medicaid matching funds states have received will gradually decrease until they reach pre-pandemic levels in December.

The consolidated appropriations act also ended more generous food assistance benefits through the federal SNAP program on Feb. 28 — delivering a double-whammy to financially-strapped people. The Legislature approved and Gov. Phil Murphy signed into law last month a measure that would create a minimum $95 Supplemental Nutrition Assistance Program benefit in New Jersey, up from $50. The increase is not expected to make up the entire loss of pandemic SNAP aid for the average family, which anti-hunger activists estimated to be about $190.

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The broad income guidelines for Medicaid have not changed.

Children under 19 qualify if their household income does not exceed 355% of the federal poverty level, which is $8,875 per month or $106,500 a year for a family of four.

Adults 19 to 64 years old qualify for coverage if they earn no more than 138% of the federal poverty level, which is $1,677 month and $20,124 a year for a single person and $2,268 month and $27,216 for a couple.

Pregnant people earning 205% of the poverty level ($5,125 per month and $61,500 a year for a family of four) are eligible and may remain covered for the first year of the newborn's life.

Undocumented immigrant children are eligible for coverage under a new policy change announced by Gov. Phil Murphy that took effect this year.

New Jersey will mail out redeterminations across the 12-month period from April 2023 through March 2024, Langer Jacobs said. The state and county boards of social services are teaming up with the five managed care organizations that provide the coverage to supply contact information and send out reminders.

Human Services also created the StayCoveredNJ website, with information translated into 21 languages.

County and state officials are prepared to restore people's enrollment quickly — some within a few days — if people have been terminated in error, she said. People may also request a hearing to challenge a termination, Langer Jacobs said.

The state has upgraded its information technology systems to handle the onslaught of applications, she said.

If people no longer qualify for NJ FamilyCare and need insurance, they will very likely find affordable options on the Affordable Care Act marketplace, Langer Jacobs said. The Medicaid office can transfer the information to the state Department of Banking and Insurance and its GetCoveredNJ online portal to the state's health insurance marketplace, she said. People can compare plans and find out if they qualify for subsidies to help pay for their premiums.

Nine out of the 10 of the 341,000 who obtained insurance through the state marketplace receive financial assistance, according to an administration announcement.

Sen. Joseph Vitale, D-Middlesex, has sponsored a bill that would make the path from NJ FamilyCare to the state's commercial marketplace even easier. The bill, (S3607) requires the departments of Banking and Insurance and Human Services to work together so people dropped from NJ FamilyCare are automatically enrolled in the lowest-cost, silver-tier plan so there is no interruption in coverage.

The Senate Health, Human Services and Senior Citizens Committee approved the bill Monday, by a 6-2 vote. The bill still needs to pass the full 40-member Senate and repeat the committee hearing process in the Assembly, followed by a floor vote in the 80-member lower house before it goes to Murphy's desk for signature.

New Jersey Citizen Action, a consumer advocacy organization, and Planned Parenthood Action Fund of New Jersey testified in support of the bill.

"Efforts to remove barriers to ensure continuous coverage for these residents is essential for them and for our health system," Laura Waddell, Citizen Action's Health Care Program Director told the committee.

The bill wasn't a hard sell. It won bipartisan support. "This could be very serious for people," Sen. Robert Singer, R-Ocean about the loss of coverage for thousands of people. "This is a step in the right direction."

To learn more about reapplying for Medicaid/NJFamilyCare, call the NJ FamilyCare help line at 1-800-701-0710 (TTY: 711) or visit StayCoveredNJ.

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Susan K. Livio may be reached at [email protected]. Follow her on Twitter @SusanKLivio.

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