Governor Phil Murphy has announced that New Jersey will operate its own “state-based health exchange” for health insurance starting in 2021. Currently, residents who buy their own healthcare do so on the federal exchange at Healthcare.gov under the Affordable Care Act. But according to Murphy, the move to a state-based exchange will “allow New Jersey greater control over its health insurance market and the ability to establish stronger protections against the Trump Administration’s sabotage of the ACA.”

Murphy has also proposed codifying in state law the protections provided by the Affordable Care Act, the governor said in a press release.

Days after Murphy’s announcement, the Trump administration argued in a federal appeals court that the ACA’s protections for people with pre-existing conditions, along with its expansion of Medicaid and every other aspect of the law should be invalidated.

Murphy said the state-based healthcare moves were intended as a safeguard to preserve the benefits of the ACA for New Jersey residents.

“New Jersey has not shied away from the work required to secure the protections afforded by the Affordable Care Act and to provide access to quality affordable health care that our residents deserve — in fact, in partnership with the legislature our state has stepped up,” Murphy said. “We have the ability to further protect New Jersey from actions taken by the Trump administration to roll back the hard-fought protections afforded by the ACA, and I would argue we have an obligation to do so.”

“Moving to a state-based exchange is the right next step in our work to improve access to coverage and care,” said Department of Banking and Insurance Commissioner Marlene Caride. “The federal government has cut the enrollment period, and slashed funding for outreach, advertising and navigators that provide critical assistance to residents in our communities. Funding sent to Washington to utilize the federal exchange will be better utilized right here in New Jersey, where we can establish policies that create greater stability, access and improved protections for residents.”

New Jersey has already established a reinsurance program, implemented a requirement to have coverage, and took over plan management of the exchange in New Jersey. The Murphy administration said rates in the individual market went down by 9.3 percent this year as a result of these efforts.

The Texas v. Azar case, currently pending appeal in the Fifth Circuit, threatens the ACA. New Jersey had many of the ACA consumer protections in state law before the ACA was passed. However, state law has not been updated in all respects to incorporate the ACA protections. In the event the ACA were overturned in the courts, or further destabilized at the federal level, significant reforms to New Jersey law are required to maintain the ACA consumer protections.

The administration proposes codifying many of the primary ACA consumer insurance protections including: Prohibiting pre-existing conditions exclusions, requiring dependent coverage to age 26, requiring coverage of “essential health benefits,” prohibiting lifetime and annual limits, and requiring coverage without cost sharing for preventative services.

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