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State Implementation
 Temporary High-Risk Pool
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NJ DOBI filed a letter of intent to Secretary Sebelius to use the
state’s individual health coverage market as its temporary highrisk pool.
NJ already has “guaranteed issue,” meaning high-risk pool will
have little overall effect on coverage.
 Health Insurance Exchange
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By Jan. 1, 2014, states must have an operational health
insurance exchange run independently by the state, or in
conjunction with other states. Federal start-up funds become
available next year for states.
Secretary shall determine benefits, but broken up into Bronze,
Silver, Gold and Platinum packages.
Reinsurance Pool – Health Care Choice Compacts
Source: New Jersey Hospital Association
Copyright 2000, New Jersey Hospital Association
State Implementation, cont’d
 Insurance Reform
 Market Reforms – coverage for dependent children, ban
on pre-existing conditions, guarantee issue etc.
 Premium Review – NJ eligible for $1 million this year
 Medicaid Expansion
 Beginning Jan. 1, 2014, Medicaid coverage will be
expanded to 133% of the federal poverty level for nonelderly individuals
 States will receive greater federal match for cost of
expansion
 Early expansion option
Source: New Jersey Hospital Association
Copyright 2000, New Jersey Hospital Association
Tax Exempt Status
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Community needs assessment
Financial assistance policy / charge limits
Debt collection
Reporting disclosure
State legislation – conflicts of interest,
quarterly public meetings, charge
limitations etc.
Source: New Jersey Hospital Association
Copyright 2000, New Jersey Hospital Association