The repeal of the Affordable Care Act, without a viable replacement, could be a devastating financial hit for New Jersey, where 18 percent of the economy is rooted in health care, according to Raymond Castro.
Castro, a senior policy analyst at New Jersey Policy Perspective, said that, in fact, growth in the health care sector “kept the state afloat” during the economic recession.
NJPP co-released a new chartbook with the New Jersey for Health Care Coalition, which provided county by county data on the number of people that have Medicaid and Marketplace coverage at stake.
The data also showed the loss of federal funds and health care jobs as a result of a repeal in 21 counties.
The greatest impact would be Essex County, which would see a total loss of coverage for 100,000 residents and about half a billion dollars in federal funding, Castro said.
In addition, of the estimated 86,000 jobs statewide that would be lost, 9,000 are in Essex County.
The lowest impact would be in Salem County, where more than 7,600 residents would lose coverage, nearly $30 million would be lost in federal funding and about 600 jobs would be lost.
A key concern is not just the fiscal impact for the government, industry and residents, but in addition, the utilization trends that were achieved with broader access to coverage in recent years.
Peter Kaprielyan, vice president of government and external relations at Inspira Health Network, said that those who gained access through the marketplace subsidies and Medicaid expansion were weaned off of the emergency department as a primary care option, and increasingly sought care from primary care and specialty doctors.
That trend could reverse if coverage is eliminated, taxing emergency departments and making health care costly again.
About 30 percent of the population in Cumberland County is on Medicaid, so the loss to the health system could be significant.
Inspira covers Cumberland, Gloucester and Salem counties and stands to lose nearly $30 million annually from the loss of Medicaid patients, Kaprielyan said.
In a city like Camden, where the focus of redevelopment was in part on the health care sector, the economic impact of the repeal of the ACA is also significant.
“The economic impact is greatest in our urban areas,” Castro said.
Employer-based plan designs are also at stake because even if the state tries to address some of the protections built into the health plans, the state can only regulate 30 percent of market, Castro said. Larger employers and self-funded plans were addressed by the ACA.
“The ACA is getting more popular as people find out what they are going to lose,” Castro said.