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New Jersey FamilyCare (Medicaid)
Release Date: September 20, 2005
Information from the NJ Division of Medical Assistance and Health Services regarding
- New Jersey's FamilyCare program began as NJ KidCare in 1998. It was expanded and renamed NJ FamilyCare in 2000.
- The goal of this legislation was to provide health insurance for low-income children whose family incomes were too high for them to be eligible for traditional Medicaid but also too low for them to be able to participate in a private or employer-sponsored health insurance program. It is funded with State and Federal dollars.
- Our goals have not changed. We want to provide health insurance and access to quality health care to all children and parents whose family incomes or employment do not afford them the chance to get health insurance on their own.
- By mid-2001, we reached an all-time enrollment high of 180,000 adults enrolled and faced the challenge that we would run out of federal funding to support the parent piece of the program and as a result jeopardize the enrollment of children.
- Because of this, in June of 2002 we made the extremely difficult decision to stop enrolling parents and adults. Budgetary concerns forced us to face this decision.
- But today, I am very happy to tell you that we will reopen the NJ FamilyCare program to parents in families with incomes below 133% of the Federal Poverty Level. This is $25,736 annually for a family of four; $2,144.66 per month.
- When we froze enrollment for these same adults three years ago, we had 89,000 parents covered in NJ FamilyCare. Today we have 48,000 and if we continued this freeze for these parents, next June we anticipate this number would drop to about 39,000.
- Now by reopening the program in September 2005, we anticipate that we will be able to insure approximately 75,000 additional parents over the three year phase-in period. That is an 156% increase over the number of parents enrolled today.
- In addition, effective January 2006, we will also begin to allow a buy-in so that those uninsured families can choose to purchase insurance coverage from the State.
- One of our major considerations for implementing these initiatives was how to fund them. I am pleased to say that we are able to pay for most the cost of these initiatives through the implementation of pharmaceutical rebates in our General Assistance program. Only an additional $6 million is needed for the State fiscal year 2006 budget.
- And it doesn't stop there. We know our application process can be confusing so we're taking steps to simplify our application and the process to get people enrolled.
- Starting this summer, we will be using a one page application. We've reduced the number of pages in the application from 18 to 1. We're only asking for the information we absolutely need to get parents and children on the program. Note***
- We have streamlined our Presumptive Eligibility (PE) process. In this process, we give someone immediate and temporary insurance while we continue the application process.
- Instead of the two page process we now use, our PE sites, usually hospitals and Federally Qualified Health Care Centers, will use the one page application.
- We've eliminated the form that clients completed to pick an HMO. That information is now on the one page application.
- And we're expanding our use of existing databases to verify income and employment.
- One of the things we've found is that often our own Departments can effectuate great change when combining resources. So I've directed the Departments of Education and Human Services to work closely together to develop ways to reach uninsured children in our school systems.
- Staff from these two Departments have met and developed joint initiatives directed at getting children in our school system insured.
- These initiatives include meeting with Preschool staff and providing them with training on NJ FamilyCare so that they can help parents complete the one page application and meeting with County Superintendents and school nurses from the Abbott school districts to help them learn and have easy access to NJ FamilyCare. I have asked Department of Education staff to identify children without health insurance so that we can outreach them for NJ FamilyCare.
- I'm excited to be able to tell you about these wonderful new initiatives that will allow us to cover more uninsured children and their parents.
- Today we insure approximately 930,000 New Jersey children and adults. That includes 536,000 children and nearly 400,000 adults.
- Estimates of the uninsured in New Jersey run anywhere from 101,000 to 264,000. These estimates vary based on a number of factors including the number of immigrant families in New Jersey and the amount of time individuals have been uninsured. Regardless of which estimate you use, we have too many uninsured.
- We are also pursuing a federal waiver which, if approved, will allow us to enroll an additional 19,000 childless adults over the next three years.
- We believe that these reforms that I have outlined today will bring another 150,000 children and adults into our programs. This moves us toward our goal of insuring all eligible New Jersey citizens.
- We will continue to explore ways to streamline and simplify our processes and we will continue to work with advocates and community leaders to reach more of the uninsured in New Jersey and we will continue to work with the legislators in our state to reach our goal to provide health insurance and access to quality health care to children and families in New Jersey.
- I believe we're on the right track and we're moving in the right direction. And that direction is to cover as many of the uninsured children and adults in New Jersey that we can.
The shortened application is not applicable if the person is also applying for TANF, General Assistance, Food Stamps, or Emergency Assistance.
The Sussex County Division of Social Services will advise of the shortest possible application allowable when the person is applying for multiple programs. (973) 383-3600
Sussex County Division of Social Services