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Increasing uncertainty and hostility surrounding the federal Affordable Care Act (ACA) have resulted in a burst of health insurance reforms at the state level. For example, Washington recently passed a law creating a public option health insurance exchange.
Now, New York and New Jersey are also attempting to safeguard the ACA’s protections by enshrining and even expanding them at the state level. In the past few weeks, New Jersey lawmakers have introduced a multitude of health insurance reform bills, and New York lawmakers held a hearing on the feasibility of a single-payer system.
In March 2019, New Jersey Governor Phil Murphy sent a letter of intent to the Centers for Medicare and Medicaid Services, documenting New Jersey’s intention to establish a state-based health benefit exchange, to be operational by 2021.
Two months later, on May 13, New Jersey lawmakers introduced the New Jersey Health Insurance Marketplace Act (A5247, S551) to make good on that promise and establish a New Jersey health insurance marketplace. That same day, they also introduced a bill (A5248, S562) to require insurance plans to cover ACA-type essential health benefits.
Even more recently, New Jersey lawmakers have introduced a slew of additional health insurance reform bills that would further defend the state-based health care plans and marketplace:
With these bills, New Jersey is working to create a comprehensive scheme of laws and regulations that will govern a state-based health care program.
New York has also recently taken steps toward health insurance reform. On May 28, New York lawmakers held a hearing on the New York Health Act (A05248, S03577), which would create a single, publicly funded system for all New Yorkers, regardless of income. Proponents argue the Act will address holes in the current system by cutting costs, reducing coverage denials, and making co-pays more affordable. Opponents argue it will result in hospital closures because reimbursement for services could be set at below-cost Medicare and Medicaid rates. They also argue it will eliminate jobs within the private insurance industry.
Barak Bassman and Sara Richman are partners in Pepper Hamilton’s Health Sciences Department, a team of 110 attorneys who collaborate across disciplines to solve complex legal challenges confronting clients throughout the health sciences spectrum. Tracy Rhodes is an associate in the Health Sciences Department.
The material in this publication was created as of the date set forth above and is based on laws, court decisions, administrative rulings and congressional materials that existed at that time, and should not be construed as legal advice or legal opinions on specific facts. The information in this publication is not intended to create, and the transmission and receipt of it does not constitute, a lawyer-client relationship.