HHS Approves New Jersey Plan to Expand Medicaid

HHS Approves New Jersey Plan to Expand

Medicaid to Nearly 70,000 Uninsured Residents by 2013

Overview

            Nearly, 70,000 uninsured New Jersey residents will soon get new health care benefits under a Medicaid waiver granted today by HHS Secretary Kathleen Sebelius.

            Today’s action will allow the state to cover groups that were previously unable to get health insurance but will be covered under new rules in 2014.  The Affordable Care Act will expand the Medicaid program in 2014 to include all uninsured Americans whose income is up to 133 percent of the federal poverty level (FPL).  The FPL for 2011 for an individual is $14, 484.

Under the new plan, the state will be building upon its state-funded Work First New Jersey general assistance program by providing Medicaid equivalent benefits to non-pregnant women and childless adults.

The waiver approved today will allow the state to extend a package of essential Medicaid benefits to low-income residents aged 19-64 who are not eligible for traditional Medicaid and who may not be able to get private coverage. State officials estimate that 57,000 New Jersey residents will be immediately eligible for coverage with another 10,000 qualifying by 2013.

 The benefit package will include medically necessary health care services although they may be reimbursed through different programs.  In-patient hospitalization, for example, will be paid by the state’s charity care program while substance abuse services will also be provided by a state-funded program.  The source of payment will not cause any disruption of care to the enrollees.