Gov. Chris Christie vetoed the Legislature’s health benefit exchange bill on Wednesday, saying he wants answers to questions about the potential cost to the state of the exchange -- a key component of the Affordable Care Act.
But backers of the bill -- a mix of Democrats and healthcare advocates -- said that Christie has already vetoed similar legislation, and many of his objections were addressed in the most recent version of the measure.
“The governor’s veto is the latest in a long line of delays -- with ever-changing reasons,” said Raymond Castro, senior policy analyst for New Jersey Policy Perspective, a think tank focused on the needs of low- and moderate-income families.
Christie's announcement came on the deadline for taking action on the bill (S-2135). But he will have other opportunities in the next few months to take action on creating a statewide health exchange -- a virtual marketplace where individuals and small businesses can purchase private or subsidized insurance.
The U.S. Department of Health and Human Services has set a December 14 deadline for states to determine whether they will operate their own exchanges, or leave it to the federal government to provide one.
But New Jersey and other states have until February 15 to decide whether to enter into a partnership with the federal government. This arrangement would give the state responsibility for managing the exchange and assisting consumers, while the feds would oversee applications, enrollment, and financial management.
In his veto announcement, Christie said the federal government hasn’t given states enough information to decide whether to have a state-operated exchange, a federal-state partnership or one run only by federal officials.
“I will not ask New Jerseyans to commit today to a state-based exchange when the federal government cannot tell us what it will cost, how that cost compares to other options, and how much control they will give the states over this option that comes at the cost of our state’s taxpayers,” Christie said.
Castro sees things from a different perspective.
“The first exchange bill was vetoed so the governor could wait for the U.S. Supreme Court decision." he said. "After the court upheld the Affordable Care Act, the governor said he wanted to wait to see if a Romney presidency would successfully dismantle the law," he continued. "Now the governor says the state has not received enough information from the federal government.”
The exchange website would make it possible for individuals and small business owners to research and purchase health insurance.
The sites would also let residents determine if they are eligible for subsidies to purchase insurance. Subsidies will be available to residents whose income is between 100 percent and 400 percent of the federal poverty line, currently between $23,050 and $92,200 for a family of four.
The legislative battle over the bill has focused on the authority and composition of the board that would oversee it. Consumer advocates supported the bill, in part, because the board would be made up of experts who didn't have a financial stake in the insurance industry. They also praised a provision stipulating that the board certifies plans with the “optimal combination of choice, value, quality, and service to enrollees.”
However, insurance industry officials said the board should include industry representatives, and that residents should be given the ability to choose their own plans without the board limiting the selection.
Christie wants answers to a series of questions posed by the Republican Governors Association. These include: What will be the cost of state-federal partnerships? How will federally run exchanges operate? And how does the administration plan to pay for exchanges when Republican members of Congress have said they would block funding?
Christie has said that the Affordable Care Act will be the law of the land after Obama’s re-election and that his opposition to specific bills was not an effort to thwart the ACA's implementation. However, at a press conference on November 19, Christie said he “wouldn’t buy a pig in a poke.”
“If they’re willing to answer the questions, and I can evaluate how much it’s going to cost, then I might be inclined to do a state-run exchange,” Christie said of federal officials. “If they’re unwilling to answer the questions for me, then they’re going to run it.”
A key point is how the exchange will be funded. To pay for federally operated exchanges, federal health officials recently proposed a 3.5 percent fee on insurance purchased through the exchanges. In the veto announcement, Christie administration officials questioned if a similar fee would be shared with state governments in partnership exchanges.
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