N.J. Group Working On Mandatory Health Insurance Plan

New Jersey lawmakers and policy experts are working on a plan to overhaul the state’s health care system that would require all New Jerseyans to carry medical insurance but would keep the policies affordable for low-wage earners.

The universal health care plan seeks to provide health insurance for the 1.4 million adults and children who don’t currently have it.

The blueprint now being crafted for introduction in the Legislature next spring would force residents to get health insurance and would require them to prove they have it when they file their state income tax returns.

People without insurance would join a state-subsidized HMO or PPO. Uninsured people who show up at a hospital for emergency treatment would be enrolled on the spot. To help pay for the coverage, the state would reallocate the $983 million it now spends on charity care and grants to hospitals for caring for the uninsured.

“What we’re proposing is some ways to redirect some of that (charity) care — to be better stewards of the taxpayers’ dollars,” said Sen. Joseph Vitale, chairman of the Senate Health, Human Services and Senior Citizens Committee, and an architect of the plan.

Vitale, who spearheaded a prior state-sponsored health insurance reform that now covers 200,000 children and families, said the current charity care system makes little sense and needs to be revamped. For example, the only medical care many of the state’s uninsured receive is treatment in the ER, which wastes money and medical resources.

The state would have to kick in some money, especially up front, to cover the estimated $1.7 billion first-year costs of the universal insurance program. That could make the plan a tough sell to lawmakers facing re-election in November.

Gov. Jon S. Corzine has expressed support for the concept of universal health insurance, and indicated in an interview with The Associated Press last week that health care reform will be a top priority in 2007, after property tax reform.

The concept of universal health care has been debated nationally for years, and several states besides New Jersey are considering the issue. But only Maine, Massachusetts and Vermont have enacted universal coverage laws to date.

New Jersey has more than twice as many uninsured residents as the number living in those New England states combined, however. New Jersey’s uninsured includes 614,000 who earn too much to qualify for existing subsidized programs, 400,000 who are in the state illegally, and 300,000 who are eligible for Medicaid or FamilyCare, but are not enrolled.

“You’re going to find a lot of states paying attention to this,” David Knowlton, president of the New Jersey Healthcare Quality Institute, a public policy group, said of New Jersey’s reform effort.

That’s because all over the country employers are dropping or scaling back on health insurance for employees because of skyrocketing costs. Knowlton said the trend means more uninsured people are burdening the health care system, forcing taxpayers to shoulder more of the weight in charity care costs.

Knowlton is chairman of a 20-member working group convened by Vitale to study the issue and help draft legislation. The group, which includes hospital and insurance representatives, lawmakers, health care policy advisers and others, has been meeting since August.

Key aspects of their working proposal, which is still being drafted, include:

The state would offer one state-sponsored plan for people who do not have employer-based medical coverage.

Low-income residents would pay on a sliding scale, depending on how much they make. The fees have not yet been determined.

Everyone would be required to have health insurance, just like they are required to carry auto insurance.

Businesses would not be required to offer coverage, just like the don’t now.

Vitale said he does not expect large numbers of employers to stop offering insurance if the universal coverage law is enacted, but said a study group would be included as part of the legislation to monitor the business trend and to craft remedies if too many employers quit offering coverage.