Getting it right

The state-based exchange is poised for a giant leap in 2020

Anthony Vecchione//January 13, 2020//

Getting it right

The state-based exchange is poised for a giant leap in 2020

Anthony Vecchione//January 13, 2020//

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In 2019, New Jersey officials announced that they would be moving away from the federal insurance marketplace and transition to a state-based health insurance exchange, giving the state greater control over insurance products.

Although it officially became a state-based exchange in 2019, it was still on the federal platform. In November of 2020 however, New Jersey will be up and running as a state-based exchange no longer on the federal platform.

New Jersey Department of Banking and Insurance Commissioner Marlene Caride. - STATE OF NEW JERSEY

That means that insurance plans purchased for 2021 will be purchased on the state exchange, no longer bound by the rules of the federal government.

“[G]oing into a state-based exchange allows us to start taking back control from the federal government so we can ensure our folks have all the information they need,” said Marlene Caride, commissioner of the New Jersey Department of Banking and Insurance.

Caride said that the federal government slashed the funds for the navigators and for outreach and advertising.

“What we were able to do this year by being on the state-based exchange, on the federal platform; we were able to control the issue of having our navigators and funding our navigators. We are better situated to know what works in our environment. It allows us to get data to target areas of underinsured and make sure that they get the information that is not available on the federal platform.”

State officials and health care executives will be keeping a close watch on interest in the exchange as well as enrollment numbers.

Ward Sanders, president of The New Jersey Association of Health Plans.

Even at this earlier stage, observers say support has been strong and feedback has been positive.

Ward Sanders, president of The New Jersey Association of Health Plans, said he applauds the work of the Murphy administration as well as the Department of Banking and Insurance and the legislators.

“They have really focused and done a lot on issues to ensure the residents that they have affordable options if they are purchasing coverage on their own. The establishment of the state-based exchange is one example of that.”

Sanders also lauded the grants the state has given to state navigators and organizations that provide enrollment assistance to those shopping on their own.

“They are working very hard in trying to improve the individual marketplace and make sure that there are viable and affordable options for New Jersey residents. We have been supportive of all these measures,” said Sanders.

Early promotional campaigns are getting positive feedback.

“It’s a little harder to measure success. The outreach effort is like any marketing program; it can get better over time once you figure out what works and what doesn’t,” said Sanders. “I think folks have been happy with how the state has gone about doing that.”

Sanders said hospitals have also done a good job of reaching out to New Jerseyans.

Because most people in New Jersey get their coverage through employers or Medicare and are not shopping for health insurance on their own, Sanders pointed out that the state-based exchange is vital for people who may be between jobs, are small employers, or are retired.

Technology glitches

Linda Schwimmer, chief executive officer of the New Jersey Health Care Quality Institute, said for consumers shopping for health insurance in 2020 the focus is going to be behind the scenes and the state making sure that when the transition is made from a federally run exchange to a state-based, they are going to get the nuts and bolts of it right in that first year.

Linda Schwimmer, CEO and president of the New Jersey Health Care Quality Institute.

“When the Affordable Care Act (ACA) marketplace first launched it had a lot of technology glitches, which really impacted the ability for people to sign up for a plan and that’s exactly what New Jersey doesn’t want to happen,” Schwimmer said. “They need to be out of the gate technologically ready and successful. That will likely be their focus for the individual market. Very focused on getting it right when they launch.”
Caride noted that when the ACA program was launched in 2014 the technology was new.

“Now we are going to be moving forward on technology that has been tried and has been tweaked, so we have the ability to look back and look at where the errors occurred in those years and make sure they do not happen here and improve upon that,” Caride said.

Another important piece, noted Schwimmer, once people begin to sign up, is how effective the communications will be.

This is a plus for the state of New Jersey. Having our say over how we reach our consumers and how to get the message out is important.
– Marlene Caride

“They will have all of their own data so they can really think about where to target the marketing dollars to really push the messaging out and the timing of it and to make sure that they have open and available phone lines and different supports when that crunch time comes in terms of when people start to enroll,” said Schwimmer.

For Caride the migration to a state-based exchange is win-win.

“This is a plus for the state of New Jersey. Having our say over how we reach our consumers and how to get the message out is important.”