New Jersey: @GetCoveredNJ announces record ~325K QHPs during Open Enrollment; low-income residents can now enroll YEAR ROUND!

This just in via the New Jersey Dept. of Banking & Insurance:

Governor Murphy and DOBI Commissioner Caride Announce Record Health Insurance Sign-Ups During Open Enrollment, Introduce Effort to Further Expand Health Care Access for NJ Residents  

• New Jersey Residents at Certain Incomes Can Now Enroll Year-Round In Free or Nearly Free Coverage

• Residents with a Qualifying Life Event Also Have Options to Get Covered 

TRENTON – Governor Phil Murphy and Department of Banking and Insurance Commissioner Marlene Caride today announced more than 324,000 New Jerseyans signed up for health coverage through Get Covered New Jersey during the Affordable Care Act Open Enrollment Period –  an increase of 20 percent compared to last year – and a record high in New Jersey, as residents benefited from increased affordability from expanded federal and state financial help.

Today, as part of its goal to continue to advance health equity and affordability, the Murphy administration introduced a new “Expanded Access” initiative, which allows residents at certain income levels to continue to enroll in free or nearly free health coverage through Get Covered New Jersey (GetCovered.NJ.gov).

The new Expanded Access Special Enrollment Period allows qualifying consumers with an annual household income of up to 200% of the federal poverty level ($25,760 for an individual and $53,000 for a family of four), to enroll in a health plan throughout the year. Because of the increased financial help available, this population has access to plans with low or no monthly premium.

This is something I've been planning on writing about for a few weeks now, but haven't gotten around to until now. The short version is that last June the Biden Administration announced that they were proposing offering a YEAR-ROUND Special Enrollment Period for low-income enrollees earning up to 150% FPL. The rationale for this is that thanks to the American Rescue Plan, anyone earning less than 150% FPL is eligible for $0-premium ACA exchange coverage anyway, which eliminates most of the incentive for anyone to "game the system" by "going bare" until they get diagnosed with an expensive ailment or injury before enrolling.

The actual implementation of this < 150% FPL SEP has been a bit fuzzier, however; it wasn't really an issue as long as the official Open Enrollment Period was ongoing anyway, so I haven't followed up on it until now, but I plan on a separate post about this later this week. This press release is kind of forcing my to jump on it, though.

In any event, it sounds like New Jersey is taking this one step further by allowing residents earning up to 200% FPL to enroll year-round. This is likely because NJ has their own supplemental subsidy program in place anyway, which means many in the 150 - 200% FPL bracket are also eligible for $0-premium plans as well.

“New Jersey saw a record number of residents enroll in quality affordable health coverage during Open Enrollment as the Biden Administration and the state drastically increased financial help to expand access to affordable coverage during the COVID-19 pandemic,” said Governor Murphy. “We continue to take actions based on our belief that health care is a right, not a privilege, and this new effort builds on the work we have done during our administration. By extending access to free or nearly free coverage to more New Jerseyans throughout the year, we will make health insurance more affordable and ensure residents can get the health care they need and deserve.”

Open Enrollment happens once a year, from November 1 to January 31. It is typically the only time residents without health insurance through an employer, or other program such as Medicaid or Medicare, can enroll in coverage unless they have a qualifying life event. Qualifying life events, include but are not limited to, pregnancy, marriage, the loss of health coverage, moving and a birth or adoption of a child.

“While the annual Open Enrollment Period ended on January 31st, we want to make sure that as many New Jersey residents as possible are aware they can turn to Get Covered New Jersey to sign up for coverage year-round – especially during the ongoing pandemic,” said Commissioner Caride. “New Jersey has taken steps maximize financial support so residents can find more assistance than ever before through the state’s health insurance marketplace, Get Covered New Jersey. This new Special Enrollment Period is a major step forward in our effort to promote health equity and continue to expand health care affordability and access for our residents.”

A total of 324,266 New Jersey residents signed up for health insurance at Get Covered New Jersey during the Open Enrollment Period — an increase of 20 percent compared to last year’s signups of 269,560. The number of residents signed up for coverage is a record high for New Jersey, with more consumers signing up for marketplace coverage than during any prior Open Enrollment Period since passage of the Affordable Care Act.

The record number of signups follows policy actions at the state and federal levels to significantly increase and expand financial help and to increase access to coverage during the COVID-19 pandemic. Now, nine out of 10 residents enrolling at Get Covered New Jersey qualify for financial help to make the cost of quality health insurance more affordable, and the majority of people receiving financial help have access to a health plan at a cost of $10 a month or less.

All plans offered through GetCovered.NJ.gov cover preventive services, emergency services, prescription drugs, and prenatal and pediatric care, and more, and no one can be denied coverage due to a pre-existing condition.

In New Jersey, there remains a requirement to have health coverage. Residents who do not qualify for an exemption from the Shared Responsibility Payment will pay a penalty at tax time.

To assist residents with enrollment in the marketplace, navigators are available within local communities to provide free, unbiased consumer assistance in finding the right health plan. There are now 18 organizations with navigators that can provide help to residents by phone, virtually or in person.

• Residents can learn more at GetCovered.NJ.gov or:

• Find free local assistance on the Get Covered New Jersey website;

• Browse plans now and see if they qualify for financial help with the Shop and Compare Tool.

• Get Covered New Jersey’s Final Open Enrollment Snapshot may be found here

As for the actual Open Enrollment Period (OEP) report, here's some of the key demographics:

• As of January 31st, 2022, a total of 324,266 residents signed up for 2022 health coverage with Get Covered New Jersey, including more than 123,000 new or existing consumers who actively selected a plan and more than 200,000 who were automatically renewed.

• Total plan selections are up 20 percent compared to this time last year, when 269,560 residents had signed up for coverage. The number of residents signed up for coverage is a record high for New Jersey, with more consumers signed up for the marketplace plans than during any prior Open Enrollment Period since passage of the Affordable Care Act and the start of health insurance marketplaces in 2014.

• New Jerseyans continue to receive historic levels of financial help and the average amount of financial help received during the Open Enrollment Period is $545 per person each month in savings, or $6,540 a year, compared to $485 a month last year, during the 2020 Open Enrollment Period.

• 9 in 10 people enrolling in a health plan at Get Covered New Jersey qualify for financial help, and most can find a plan for $10 a month or less.

• Additionally, for the first time during Open Enrollment, residents with an income up to 600% of the Federal Poverty Level ($77,280 for an individual and $159,000 for a family of four) qualify for New Jersey Health Plan Savings (NJ state subsidies) in addition to the federal Advance Premium Tax Credit (APTC), up from last year’s state subsidy threshold of 400% of FPL. More than 30,000 people newly eligible for expanded financial help have selected a plan and will receive nearly $250 per month in savings, or about $3,000 in savings for the year.

• Total Plan Selections 324,266
• Automatic Renewals 200,957
• Active Renewals 65,304
• New Plan Selections 58,005

• Accounts Transferred Medicaid Outbound 51,157
• Medicaid Inbound 7,954