NJ budget plan expands kids health coverage to unauthorized immigrants
TRENTON – Gov. Phil Murphy’s proposed budget includes $11 million to expand eligibility for NJ FamilyCare to children who can’t receive that health coverage now solely because they aren’t legally in the country.
Phase two of the Cover All Kids initiative, a multi-year plan to provide health insurance to the approximately 87,000 children without coverage, would take effect in January but take time to achieve its goal, given the difficulty in reaching some families and persuading them to trust the program.
“In addition to it being the right to do to provide health insurance for children, there are assumed financial benefits to the state over time because when you invest in prevention, when you invest in primary care, it saves dividends for both health care costs and for society,” Human Services Commissioner Sarah Adelman said at a Senate budget committee hearing Tuesday.
Through the Cover All Kids initiative, the state has already cut in half the number of eligible but uninsured children, through a requirement that schools notify families of uninsured kids about their Medicaid eligibility and through data provided by the state Treasury Department.
In budget documents, the Department of Human Services said Rutgers University researchers estimate that 23,912 of the 86,922 uninsured children in New Jersey in 2019 were not eligible because they are undocumented immigrants. Adelman said there are around 18,000 and that the budget assumes around 6,000 will be enrolled each year.
“Our Medicaid program is about a $16 billion program and growing, so this is a very small percentage of what we are providing to children and families in New Jersey through Medicaid,” Adelman said.
“Health care should be a fundamental right for children, and the investment will pay dividends over their lifetime,” she said. “It will make our communities healthier, and this feels like low-hanging fruit for us, for such a small percentage of our Medicaid budget to be able to do this.”
Assemblyman Hal Wirths, R-Sussex, said health care is critical for all New Jersey residents but that citizens and documented immigrants are struggling to pay for care who don’t qualify for state help.
“And the fact that the federal government is not paying for it shows it’s not something that’s broadly accepted,” Wirths said.
“With sanctuary state, free college and free health care, who the hell’s not going to want to come here?” he said.
Assemblywoman Eliana Pintor Marin, D-Essex, said she doesn’t look at the $11 million “in the form of a money signal and the 11 and all the zeroes that follow it,” given the number of kids it can help.
“We talk to different doctors and physicians that say: You know what? This would have been less of a cost if we would have gotten to this issue earlier,” Pintor Marin said. “To me, that’s what the $11 million signifies in this budget, and it is a drop in the bucket to make sure that all kids, regardless of what their immigration status, regardless of what they look like, where they came from, are being serviced when they walk into a hospital or a doctor’s office.”
Assemblyman Gary Schaer, D-Passaic, said is simply more practical to cover children so they get preventative care, rather than wait for emergency care at a hospital that the state partially reimburses for through charity care.
“The cost of an emergency room visit by a family, by a child, whether they be documented, undocumented, whatever it is, the bottom line is the cost is so prohibitive that it is cost-effective to cover the children irrespective of whatever status they have,” Schaer said.
Adelman said it costs eight times more, for example, to treat a child with an earache in the emergency room rather than through a pediatrician’s office – $400, rather than $50.
Assemblywoman Aura Dunn, R-Morris, said the Affordable Care Act requires noncitizens to wait five years to qualify for coverage through Medicaid and CHIP, the children’s health insurance program. She suggested the state of New Jersey is circumventing that bar.
Adelman said that’s not the case, as federal law only dictates what can be done with federal money.
“Until the federal government changes their own policies, we’ll be funding that through state funds,” Adelman said.
“We’re very grateful for the governor’s support to be able to do this here in New Jersey,” she said. “I imagine there are several things that are difficult to get through Congress, but I’m optimistic that over time this will be funded by the federal government.”
If it’s going to cost $11 million to cover one-third of the eligible population for six months, it could cost $66 million to cover the full population over an entire – not accounting for the effects of inflation by the time the program is fully in place in 2025.
Sen. Steve Oroho, R-Sussex, said it appears to him it could cost $100 million when it’s fully implemented but asked Adelman to provide an official cost projection. She said she didn’t have it available but would provide it.