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State Implementation

State Implementation. Temporary High-Risk Pool NJ DOBI filed a letter of intent to Secretary Sebelius to use the state’s individual health coverage market as its temporary high-risk pool. NJ already has “guaranteed issue,” meaning high-risk pool will have little overall effect on coverage.

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State Implementation

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  1. State Implementation • Temporary High-Risk Pool • NJ DOBI filed a letter of intent to Secretary Sebelius to use the state’s individual health coverage market as its temporary high-risk pool. • NJ already has “guaranteed issue,” meaning high-risk pool will have little overall effect on coverage. • Health Insurance Exchange • 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

  2. 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 non-elderly individuals • States will receive greater federal match for cost of expansion • Early expansion option

  3. Tax Exempt Status • Community needs assessment • Financial assistance policy / charge limits • Debt collection • Reporting disclosure • State legislation – conflicts of interest, quarterly public meetings, charge limitations etc.

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