NJ FamilyCare — More Information

Feds Back Down on Bad Policy

Restrictive new rules promulgated by the Bush administration through an August 17, 2007 directive issued by the Centers for Medicare & Medicaid Services (CMS) would have impeded New Jersey's ability to provide health insurance for thousands of low-income children have been put on hold.

If enforced, the rules would likley compel New Jersey to reduce the amount of income a family could make and still be eligible for coverage from FamilyCare. In response to opposition to these rules from New Jersey, other states and many national organizations, CMS issued a statement saying it will not take any compliance action "at this time."

While any delay in these rules is a good thing, CMS could still decide to implement them later. This threat could have a chilling effect on the State's effort to insure all children as required in recently passed state legislation. It also leaves unclear whether New Jersey will receive all the federal funds necessary to operate FamilyCare through the fiscal year. The State of NJ has sued the federal government on this issue and is awaiting a summary decision from the court.

New Jersey Citizen Action, New Jersey Appleseed Public Interest Law Center, Alliance for the Betterment of Citizens with Disabilities (ABCD), Alliance for Disabled in Action (ADA), BlueWaveNJ, Catholic Charities Diocese of Trenton, CWA Local 1034, CWA Local 1037, the Elder Rights Alliance of NJ, Family Voices of NJ, Health Care for All/NJ, Health Professionals and Allied Employees (HPAE), National Association of Social Workers (NASW) of NJ, National Organization for Women (NOW)—Morris County Chapter, Next Step (incorporated as People with Disabilities for Social and Economic Justice), the Statewide Parent Advocacy Network (SPAN), and the Workmen's Circle/Arbeter Ring NJ Region have submitted an amicus brief in support of the State's Complaint. Read the amicus brief.

CMS Directive

The directive issued on August 17, 2007 by the Centers for Medicare and Medicaid Services would severely limit the ability of NJ and other states to insure all children through the current SCHIP program as well as expand coverage by offering full-cost buy-ins to those with incomes above 350% FPL. The CMS directive would:

• Require applicants to have been uninsured for one year and over;
  
• Require 95% participation rate for children below 200% FPL;
  
• Require the State to establish that there has not been a 2% decrease in enrollment of private plans; and
  
• Require the State not to offer an insurance plan on more favorable terms than a competitive private plan.

New Jersey has a lot at stake. Over 124,000 previously uninsured, low-income children are currently covered under the New Jersey's SCHIP program known as FamilyCare, which constitutes the State's primary mechanism to ensure comprehensive health insurance for children residing in New Jersey.

It remains important for anyone concerned about this issue to keep New Jersey's congressional delegation informed about the serious consequences of denying health coverage to children in working families already struggling with rising energy and food costs.