Bill Text: NJ S3985 | 2024-2025 | Regular Session | Introduced
Bill Title: Requires DOBI to establish integrated enrollment platform for State-based health insurance exchange and NJ FamilyCare program.
Sponsorship: Partisan Bill (Democrat 2)
Status: (Introduced - Dead) 2024-12-19 - Introduced in the Senate, Referred to Senate Commerce Committee [S3985 Detail]
Download: New_Jersey-2024-S3985-Introduced.html
Sponsored by:
Senator RAJ MUKHERJI
District 32 (Hudson)
SYNOPSIS
Requires DOBI to establish integrated enrollment platform for State-based health insurance exchange and NJ FamilyCare program.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning the State-based health insurance exchange and amending P.L.2019, c.141.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 2 of P.L.2019, c.141 (C.17B:27A-58) is amended to read as follows:
2. a. Notwithstanding any other law to the contrary, the Department of Banking and Insurance shall have the authority to operate a State-based exchange and coordinate the operations of the exchange with the operations of the New Jersey Individual Health Coverage Program and the New Jersey Small Employer Health Benefits Program, including reorganization of the boards, as the commissioner deems appropriate. The department's authority to regulate the insurance market shall be separate and distinct from the department's duty to oversee exchange operations, to ensure the best interests of and protection for consumers of the State. The commissioner may require that all plans in the individual and small employer markets be made available for comparison on the State-based exchange, but nothing in this section shall allow the commissioner to require all plans in the individual and small employer markets to be purchased exclusively on the State-based exchange. The department shall coordinate the operations of the exchange with the operations of the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) and the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.) to determine eligibility for those programs as soon as practicable.
b. The Commissioner of Human Services, in consultation with the Commissioner of Banking and Insurance, shall submit a proposal for [available] such State plan amendments or waivers as may be necessary to implement the provisions of this section and to secure federal financial participation funds to the Centers for Medicare & Medicaid Services of the U.S. Department of Health and Human Services pursuant to 42 C.F.R. 433.112 for the Medicaid eligibility platform and the exchange to be integrated. Notwithstanding the foregoing, the Department of Banking and Insurance [may] shall proceed to implement the provisions of this act, including [the operation of the State-based exchange], in consultation with the Department of Human Services, the integration and operation of the State-based exchange with the Medicaid eligibility platform.
c. The Commissioner of Banking and Insurance shall have the authority to require that plans offered on the exchange conform with standardized plan designs that provide for standardized cost-sharing for covered health services.
d. The Commissioner of Banking and Insurance shall establish an advisory committee to provide advice to the commissioner concerning the operation of the exchange and the implementation of the New Jersey Easy Enrollment Health Insurance Program established pursuant to P.L.2022, c.39 (C.17B:27A-59.1 et al.). The advisory committee shall include at least nine members, as follows:
(1) The Commissioner of Banking and Insurance, or a designee, who shall serve ex-officio;
(2) The Commissioner of Human Services, or a designee, who shall serve ex-officio;
(3) the Commissioner of Health, or a designee, who shall serve ex-officio; and
(4) six public members, who shall be residents of the State, appointed by the Commissioner of Banking and Insurance. Each public member shall have demonstrated experience in one or more of the following areas: health insurance consumer advocacy; individual health insurance coverage; small employer health insurance coverage; health benefits plan marketing; the provision of health care services; or academic or professional research relating to health insurance.
(cf: P.L.2022, c.39, s.9)
2. This act shall take effect immediately.
STATEMENT
This bill requires the Department of Banking and Insurance (DOBI) to establish an integrated platform for the State-based health insurance exchange and the NJ FamilyCare program. Under current law, the Commissioner of Human Services is required to submit a proposal for available federal funding to integrate the Medicaid eligibility platform with the State-based exchange, but is not required to complete the integration.
Under the bill, DOBI, in consultation with the Department of Human Services, will be required to integrate the State-based exchange with the State Medicaid program's eligibility platform to create an integrated platform that allows for individuals to determine their eligibility for health benefits plans under the New Jersey Individual Health Coverage Program, the New Jersey Small Employer Health Benefits Program, and the NJ FamilyCare program, which includes the State Medicaid Program and the Children's Health Insurance Program. The Commissioner of Human Services, in consultation with the Commissioner of Banking and Insurance, will be required to submit a proposal for such State plan amendments or waivers as may be necessary to implement the provisions of this bill.
