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S 1557 - FamilyCare Expansion bill - New Jersey Key Vote

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Title: FamilyCare Expansion bill

Highlights:

-Requires that all New Jersey residents 18 years of age and younger shall obtain and maintain health care coverage that provides hospital and medical benefits either through an employer-sponsored or individual health benefits plan, the Medicaid program, NJ FamilyCare Program, or the NJ FamilyCare Advantage buy-in program (Sec. 2). -Requires the establishment of a NJ FamilyCare coverage buy-in program, called NJ FamilyCare Advantage, through which a parent or caretaker whose family income exceeds 350% of the poverty level may purchase coverage under NJ FamilyCare for a child under the age of 19, who is uninsured and was not voluntarily disenrolled from employer-sponsored group insurance coverage within six months prior to application to the program (Sec. 4). -Prohibits hospitals from submitting charity care claims to the Department of Health and Senior Services for health care services provided to a child under 19 years of age who arrives at a hospital for emergency care and who may be deemed presumptively eligible for NJ FamilyCare coverage or Medicaid coverage (Sec. 6). -Requires each individual taxpayer, beginning with the 2008 tax year, who files a resident New Jersey Gross Income Tax return to indicate on the taxpayer’s income tax return whether the taxpayer and dependents, if applicable, has health insurance coverage on the date the return is filed (Sec. 7). -Requires that the premium rate charged by the carrier for the highest rated individual or class of individuals shall not be greater than 350% of the premium rate charged for the lowest rated individual or class of individuals purchasing the same individual health benefits plan, with the rate differential among the premium rates being based on age or actual and expected experience (Sec. 9). -Provides that for the four years following the effective date of this section, in the case of a person who is 55 years of age or older who purchases a health benefits plan on or after that effective date, the annual rate increase for that person shall be 15% or the medical trend assumption used by the carrier to project claims, whichever is lower (Sec. 10). -Requires the Commissioner of Human Services to establish an enhanced NJ FamilyCare outreach and enrollment initiative using include culturally sensitive, Statewide and local media public awareness campaigns to increase public awareness about the availability of, and benefits to enrolling in, Medicaid, NJ FamilyCare, and the NJ FamilyCare Advantage buy-in programs (Sec. 26). -Requires the Commissioner of Human Services to establish an Outreach, Enrollment, and Retention Working Group that will be charged with developing a plan to strengthen outreach to low and moderate income families who may be eligible for Medicaid, NJ FamilyCare, or NJ Family Care Advantage in order to maximize enrollment and with the aim of ensuring retention (Sec. 27). -Appropriates $1 million to the Department of Human Services from the General Fund for the purpose of carrying out the enhanced NJ FamilyCare outreach, enrollment, and retention initiative (Sec. 28).

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