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Expanding health insurance in N.J. will be a tough sell

Data: Majority of uninsured have little interest in buying coverage

Nearly 1 million New Jerseyans are in line for federally subsidized health coverage in 2014 under the federal Affordable Care Act — but reaching this diverse population, and convincing it to get coverage will require the combined forces of myriad stakeholders, including government, business, health care providers, faith-based…

Nearly 1 million New Jerseyans are in line for federally subsidized health coverage in 2014 under the federal Affordable Care Act — but reaching this diverse population, and convincing it to get coverage will require the combined forces of myriad stakeholders, including government, business, health care providers, faith-based organizations and community groups.

That was the message nearly 50 of those stakeholders heard during a conference convened by the Center for State Health Policy last week in New Brunswick. Center Director Joel C. Cantor reported new data that he said reveal the magnitude of the sales job facing health care advocates in the run-up to 2014, when most Americans either must get health coverage or pay a penalty. Insurers will sell coverage to individuals and businesses on a state-run exchange, while expanded Medicaid eligibility will cover more of the state’s working poor.

A study by the center found more than 53.2 percent of New Jersey’s uninsured young adults — ages 19 to 30 — have relatively low interest in getting coverage. But that’s no surprise, Cantor said: Experts have long noted the so-called “young invincibles” often refuse to purchase health insurance because they don’t think they need the coverage — or the expense.

But Cantor said he was surprised to learn 58.4 percent of uninsured New Jerseyans ages 31 to 49 felt the same as those in the younger bracket. Cantor said the data suggest when health coverage is expanded — and mandated — many New Jerseyans aren’t going to respond “to the simple message of ‘it’s available right now, come and get it.’ It’s going to require a more nuanced message.”
Cantor said the conference revealed “a need to teach the teachers — to reach the people in the community who are going to get questions” from New Jerseyans buying insurance for the first time.

Lisa Block, senior program officer of the Healthcare Foundation of New Jersey, said it’s not surprising many of the uninsured aren’t ready to obtain coverage. “A lot of folks have always been left out for all sorts of complex reasons,” she said, including those who earn too much to qualify for Medicaid but can’t afford to buy insurance; the ACA’s federal subsidies are supposed to narrow that gap.

According to Cantor, “The low-income uninsured have existed in the system without coverage — they found ways to get care when it’s really urgent, their lives are complicated, and asking them to buy a complex product when they don’t need it at the moment is going to be really challenging.”

The conference offered an inside look at the Massachusetts multimedia blitz when the state mandated health coverage in 2007. Paul Wingle, director of creative media for the Massachusetts Health Connector Authority, said the Boston Red Sox were a key media partner — pitcher Tim Wakefield made a public service ad, and a booth at Fenway Park distributed health coverage information during home games.

Wingle said New Jersey has the challenge of a fragmented media market, with the state split between New York and Philadelphia. But that might offer an opportunity, Wingle said, pointing out that New Jersey will be pitching the same message in 2014 as New York, Connecticut and Pennsylvania.

“The New York media market is extraordinarily expensive — but why would it make sense for New York, Connecticut and New Jersey to all have separate ad buys?” he said. “Maybe you could talk to New York and Connecticut and say, ‘Could we have a unified media campaign and agree on a set of messages, and have one point of referral for all three states?'”

Ed Rogan, spokesman for the state Department of Banking and Insurance, said there hasn’t yet been any discussion of advertising collaborations with other states to get the word out to consumers, “but I think as we get closer to the time when the individual mandate comes into effect, there will certainly be a need to inform the public on this — and that is certainly an option for us.”

Wingle said Massachusetts used TV, radio, direct mail, posters in hospitals, billboards at Fenway Park, signs on pharmacy windows and at motor vehicle offices — even on the back of supermarket receipts.
“We decided to be ubiquitous,” he said. “Where the people go, that is where we are going to go.”

Most employers already are familiar with health insurance, but they will need help navigating the new exchange marketplace, said Desmond Slattery, president of the New Jersey Association of Health Underwriters. He said
brokers will be prepared “to walk employers through the process; there will be a lot of options.”

Christine Stearns, vice president for health and legal affairs at the New Jersey Business & Industry Association, said the NJBIA is taking a central role in getting employers up to speed on health reform: “Affordability of coverage is their number-one concern.”
Crystal Sneddon, health care campaign coordinator for New Jersey Citizen Action, said they key challenge will be “explaining the new term ‘exchange,’ so people understand this is an opportunity for the state to revamp access and affordability of health care for people in New Jersey.”

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Beth Fitzgerald

NJBIZ Business Events