GV | ONLY IN NEW JERSEY
WITH STEVE ADUBATO
Steve Adubato, PhD., is an Emmy Award–winning anchor for Thirteen/WNET (PBS) and NJTV (PBS) who regularly appears on the Today show, Fox 5 in
New York and WOR News Talk Radio 710. His newest book, You Are the Brand, examines the brand strategies of more than 30 individuals and companies.
For more information log on to stand-deliver.com. Find Steve on Facebook at Facebook.com/SteveAdubatoPHD.
LIKE IT OR NOT, IT’S HERE. Implementation of the Affordable Care Act—a.k.a.
Obamacare—began October 1 amid the
added confusion of a federal government shutdown. At deadline, the President and Congress were still attempting
to sort out their differences on the
budget. Despite that bump in the
road, almost 1 million New Jersey
residents now are eligible to sign
up for health-insurance coverage
through an online marketplace.
This exchange is a one-stop shop
where residents can compare insurance plans and apply for subsidies to help cover their premiums.
In New Jersey, Governor Chris
Christie has opted to have the
federal government—and not the
state—manage the marketplace. (It
can be accessed at healthcare.gov or
800-318-2596.) In all states, those
with existing insurance need not
seek coverage through the marketplace, but uninsured residents must
sign up by March 31 or pay a penalty
on their 2014 tax return, starting at
$95 per adult.
Those are the basics, but there
are still plenty of questions. For
clarity, we turned to Joel C. Cantor,
director of the Rutgers Center for
State Health Policy and a distinguished
professor of public policy.
What are the biggest challenges to implementation of the Affordable Care
Act? The nature of New Jersey’s media
market is such that it is hard to get the
information out to the public, given that
so many New Jerseyans pay attention to
the media emanating from New York and
Philadelphia. Add to that the issue of budgeting, as states that choose to implement
their own exchanges have a lot more resources to get the message out than those
relying on the federal government.
Are there other implications of the
governor’s decision to leave the Feds
responsible for the insurance market-
place in New Jersey? In terms of the
mechanism and the way the subsidies
will flow, we won’t notice any difference.
In some ways, it is more efficient for the
federal government to do this in every
state. Unfortunately, this wasn’t the plan.
Congress and the Obama Administration anticipated that more states would
do this on their own, and the lawmakers
booked the money that way. On the ear-ly-implementation and public-education
side, that is the biggest negative of the
state not doing this on its own.
Will the process be as confusing or
complicated as critics claim? The
health care system was confusing and
complicated before Obamacare. In some
ways, Obamacare has simplified some of
it. The basic structure of the health care
system is unchanged; we are just grafting
off some new parts. Anything new brings
anxiety and more complexity.
What are the biggest benefits of the
new system? The most important piece
is that affordable coverage will be available to over 900,000 New Jersey
residents. We are anticipating
that well below that number will
actually sign up, but there will be
an affordable option available for
most people who are uninsured.
The other potential benefits are
long-term—and the jury is still out
on how effective these pieces will
be, such as a change to incentives
that providers receive to deliver
higher quality and lower cost .
Primary-care physicians already are in short supply in New
Jersey. How will the new system
impact the demand for their services? There are training grants
available to prepare primary-care
providers and advanced-practice
nurses [those with post-graduate
degrees]. There are a number of
vehicles to encourage the growth of
primary care. Each of these policies
on its own is a fine thing, but the
medical-education and nursing-education pipeline is years long. These
programs...will not address the short-term
problem, so some areas will probably see a
shortage in primary-care physicians.
What do you say to those people who
would rather pay the penalty than sign
up before March 1? It is certainly an option. The penalty is not very severe. It is
the greater of $95 or 1 percent of income.
It goes up over three years, and gets more
serious over time. I don’t think any of the
close observers think it is the penalty that
will get people to enroll. Instead, it is the
opportunity to get an affordable premium
that will be the incentive....what will drive
this is the access to affordable health care. ■
Ready or Not
Obamacare has arrived. Here’s what Jersey can expect.