The new Healthcare Reform Act is slowly being enacted across the nation. Plans and activities are going on in every state and articles on health insurance news dot the Internet.

Let’s take a look at how the new reform will help residents of New Jersey:

• 1.5 million residents who do not currently have insurance and 326,000 residents who have non-group insurance will be able to get affordable insurance through the health insurance exchange.
• 854,000 residents will be able to qualify for premium tax credits to assist in  purchasing health coverage.
• 1.3 million seniors will be eligible to receive free preventive services.
• 227,000 seniors would have their brand-name drug costs in the Medicare Part D “doughnut hole” halved.
• 107,000 small businesses could be helped by a small business tax credit to make premiums more affordable.

Let’s examine how families of New Jersey will be affected by the proposals implemented in 2010 and 2011:

The 8.7 million residents of New Jersey will benefit as reform is meant to:

• Ensure consumer protection – Insurance companies will no longer be able to place lifetime limits on the coverage they provide nor arbitrarily drop coverage.
• Create insurance options for the uninsured – Healthcare Reform will establish a high-risk pool to enable people who cannot get insurance today to find an affordable health plan. New Jersey has not created a high-risk pool as of yet.
• Ensure free preventive healthcare services – Health insurance reform will ensure that people can access preventive services for free through their health plans.
• Supports health coverage for early retirees. A reinsurance program would stabilize early retiree coverage and provide premium relief to both the retiree and the worker in a company that provides employee health benefits. 

The entire healthcare reform act will not be implemented until 2014; however, small implementation steps are already having a positive impact on the resident’s of New Jersey.

Many small-business owners in New Jersey are still puzzled over how—if at all, the new health care reform will directly affect them. The health care reform legislation is cumbersome and small-business owners are curious and confused.

Under the health care reform act, companies with more than 50 employees must provide affordable coverage or pay a fine of up to $2,000 per employee, excluding the first 30 employees.

Scott Goldstein, spokesman for the state Chamber of Commerce, said it was difficult to predict how this requirement would affect their members. Of the group’s 1600 members, roughly half have more than 50 employees and many of the businesses provide their employees with health care coverage. “It might come down to whether they meet the minimum standards,” he said, which lawmakers have yet to specify.

The New Jersey chapter of the National Federation of Independent Business questions the effectiveness of the health care reform act’s subsidies for small-businesses.

Under the new legislation, a business with less than 10 employees with an average annual wage of under $25,000 would be eligible for tax credits of up to 50 percent of the employer’s contribution. State director Laurie Ehlbeck stated “Few small businesses will actually qualify,” noting the group’s 8,000 New Jersey members pay an annual salary of $27,000.

There is also confusion with how the new health care reform treats part-time employees. Nancy Lurker, CEO of Parsippany-based PDI, Inc., which outsources services to pharmaceutical companies. “It’s very murky,” she said, “If there’s uncertainty, you don’t hire.” About half of PDI’s 120 New Jersey employees are part-timers and extending coverage to them as well as the full-time employees would have a direct effect on the company’s hiring and expansion plans.

On the other hand, John Sarno, president of the Employers Association of New Jersey sees small-business owners as being shortsighted by only looking at the cost. He said the bill represented a win-win situation because companies with fewer than 50 employees who don’t offer health care coverage would not be required to make any changes.

New Jersey Republican Governor Chris Christie is making health insurance headline news hourly it seems! The governor is cutting low-income programs and referring to “shared sacrifice” as he tackles the budget crisis New Jersey is experiencing. 

The “shared sacrifice” motto paints a pretty picture of everyone carrying and equal share of the burden, but according to the New Jersey governor, “Not every cut is equal, and not everyone shares the same definition of “shared sacrifice.”

As the budget cuts are rolled-out it is becoming clear that not everyone is making the same shared sacrifice. New Jersey economic situation is dire and ahs been compared to the Great Depression, so it is undeniable that state spending cuts are needed and that every area of state government will be affected. However some cuts are worse than others. The one most effective group will be those living on fixed incomes.

Governor Christie’s plan forces senior citizens to pay more for their prescription drugs. The New Jersey Foundation for Aging estimates the governor’s plan for higher prescription drug deductibles and co-pays would cost the average senior citizen an extra $430 per year. In a world where people live week-to-week, this is an increase of approximately $35 per week.

Other highlighted area’s that focuses on senior citizens include:

• Implement a new $310 deductible to 105,000 senior and disabled citizens in the Pharmaceutical Assistance to the Aged and Disabled prescription drug program and 23,000 senior citizens enrolled in the Senior Gold prescription drug program. 
• Double co-payments on brand-name prescription drugs for those senior and disabled citizens.

The Democrats plan would spread the sacrifice to the 16,000 residents who have a taxable income of $1 million. Their plan implements a temporary tax that would help more than 600,000 senior and disabled citizens who struggle to pay for medication. The Democrats feel that their plan spreads the pain and protects the states’ most vulnerable.

New Jersey’s fiscal year begins on July 1 and Governor Chris Christie has been busy proposing budget cuts. One of his proposed cuts directly affects low-cost health insurance for low-income families and immigrants of the state.

Governor Christie’s total budget for the state is $29.3 billion and he proposes to save $29 million by eliminating resident immigrants from Family Care, which is the state’s low-cost health insurance program. The proposed cut will also save an additional $24.6 million by closing off the program to thousands of working low-income parents who were projected to sign-up this upcoming year.

The monetary savings are very attractive but the proposed budget-cuts will have a direct affect on 12,000 resident immigrants and 39,000 parents will be denied eligibility in the upcoming year. The Family Care program would remain in intact for the 200,000 adults and 148,000 children currently enrolled.

Health and Human Services Commissioner Jen Velez expressed concern with the debt-ridden states ability to fully fund worthwhile programs including Family Care. The Human Services budget of $11 billion currently funds five psychiatric hospitals, seven developmental centers and many other programs and services for low-income and immigrant residents.

The proposed budget cuts totaling about $182 million were made to minimize the impact on services provided. Velez said the state would lose approximately $108 million in federal matching funds if the services provided by the Health and Human Services Department were cut to 15 programs, as proposed.

With limited state resources for low-income families, concerns are Governor Christie’s budget cuts will increase emergency room visits and decrease preventative care for the working poor of New Jersey.

The Centers for Medicare & Medicaid Services (CMS) announced in May that New Jersey’s Medicaid program will receive federal matching funds for state planning activities necessary to implement the electronic health record (EHR) incentive program established by the American Recovery Act of 2009 (Recovery Act). This is a key step to further states’ role in developing a U.S. health information technology (HIT) infrastructure.

The Recovery Act provides a 90 percent federal match for state planning activities to administer the incentive payments to Medicaid providers and ensure proper payments through audits. New Jersey will receive approximately $4.93 million in federal matching funds.

New Jersey will use its federal matching funds to gather information on issues such as existing barriers to its use of EHR’s, provider eligibility, and to complete a comprehensive study to determine the current status of HIT activities in the state. Experts from the medical industry, health insurance industry, government, and private enterprise have been pondering the need for a national database. The dilemma is how to overcome technological and regulatory barriers in order to create the medical records database and use EHR’s.

With the new healthcare reform laws, Electronic Medical Records are set to be implemented by 2015. If doctor’s offices are not compliant they will face fines.

Federal grant incentives are in place for physician’s to make the investment now. The investment being software, equipment, consultants, and training; which is going to be costly. Some physician’s are of the mind-set that it won’t matter since they are planning on retiring before the deadline arrives, others are contemplating retiring early to avoid the perceived “hassle of the transition.”

EHR’s are being implemented to improve the quality of heath care for citizens of New Jersey and make their care more efficient by providing medical information electronically to various providers who may be treating the same Medicaid patient.

“We congratulate New Jersey for qualifying for these federal matching funds to assist its plan for implementing the Recovery Act’s EHR incentive program,” said Cindy Mann, director of the Center for Medicaid and State Operations at CMS. “Meaningful and interoperable use of EHR’s in Medicaid will increase health care efficiency, reduce medical errors and improve quality-outcomes and patient satisfaction within and across the states.”