TRENTON – Health-care advocates and N.J. congressmen who support the Affordable Care Act’s tax credit program for low- and middle-income residents championed the attempt to expand coverage for those who have been historically priced out of the market.
Following up on the release earlier Wednesday of a report that spelled out benefits for some of the needier state residents who will be able to participate in the so-called health care exchanges, one of the proponents called it a “game-changer.’’
Ron Pollack, executive director of the Washington-based group that issued the report, Families USA, said today that “Our job is to make sure that people understand help is on the way.”
Among the points ACA tax-credit program supporters sought to make today:
*Exact premium costs for residents will be unknown until all providers have submitted bids for the exchange, the enrollment period for which opens Oct. 1 and ends March 31;
*The coverage that will be available for eligible residents won’t be the kind of skeletal coverage such residents had to put up with in the past, but ideally it will actually be the kind of coverage that keeps residents from turning to emergency rooms and provides them access to a primary care physician;
*Residents won’t have to pay up-front and then fight to get reimbursed. Rather, the money will be paid directly to the insurance company selected by the individual;
*And because emergency rooms will be used less frequently, hospital surcharges on insured residents for that uncompensated care will be reduced over time as well.
“This is designed so that families can benefit right away, and they are not having to spend money of their own up front,” said U.S. Sen. Bob Menendez, D-N.J. “This is an efficient way of helping families achieve their goal” of affordable care.
And U.S. Rep. Frank Pallone, D-N.J., said, “It’s important that people understand that now when you buy health insurance you are getting a good benefit package.”
There are going to be growing pains.
One of the problems that Congress still has to correct affects individuals who under ACA will be allowed to opt out of employer coverage if it exceeds 9.5 percent of their income and enter the health care exchange.
The problem is that family coverage is higher than individual coverage, so it could present a tough choice for such families.
But regarding the exchanges and the tax credits in general, “Relief cannot come soon enough,’’ said Ray Castro of N.J. Policy Perspective. “Over half of the small employers in New Jersey do not offer any coverage at all. That’s pretty shocking.”
In addition, uncompensated care at hospitals tops $1 billion a year, Castro said, and costs insured people more than $1,000 a year to help pay the hospitals, part of the so-called “hidden surcharge.”
A critical issue, the advocates said today, is an intense public awareness campaign so that the roughly 610,000 residents who are eligible for the tax credits will realize what options exist.
“We all benefit from people gaining coverage,” Pollack said.