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ACA Has Caused More Pain in NJ

Jul 11, 2018

To the Editor:

I wish to disagree with the letter written by Jo Meinhart (“Save the ACA,” 7/4). Ms. Meinhart’s facts are incorrect and skewed and show that she wrote her letter from a political perspective after doing little if any research.

She claims that only the ACA was able to provide accessibility to health care when people have pre-existing conditions. For New Jersey residents, that is absolutely incorrect for the last 30 years. Let’s take that apart.

New Jersey has the highest medical insurance costs in the country because of how the state has mandated insurance companies to operate over the past 30 years. Rates are high because New Jersey law permits, and may encourage, people to wait to enroll in a medical insurance plan until the day the pain hits. Then, by state law, all medical insurance companies doing business in the state are required to accept all comers regardless of their health status. This was not brought on by the ACA.

Any insurance is a risk pool and is not a charity. Plus, there are responsibilities of society and the public to make sure that the risk pool does not fail. It works when there is a very large cross section of the insurable public actually enrolled in coverage and who keep that coverage year after year, claims or no claims.

The problem with New Jersey law over the last 30 years is that it permits people to enter coverage on that day when the pain hits and to drop their coverage when the pain stops. Several million people in New Jersey have done precisely that, forcing the remaining members of the risk pools to increase their costs so the pools can handle claims of people who do not maintain coverage but, all of a sudden, want in with active claims. That is a self-inflicted, irresponsible condition for people to act in such an antisocial manner. But all decisions have unintended consequences. 

This law, to a large degree, ruined the medical insurance risk pool for those who took the mature road and have maintained medical insurance through thick or thin and could only be saved with massive rate increases, far more than what took place in other states.

I will also point out that if a person living in other states maintains coverage, even if they switch between medical plans, those pre-existing conditions are covered. A situation in which people who have group medical insurance through an employer and leave that employer’s employ but do not apply for a COBRA coverage extension, consequently having no coverage and insurance, never works when you impose the conditions that New Jersey has had for 30 years. The ACA imposed New Jersey-like regulations on the rest of the country.

If coverage is unavailable due to a person’s own poor judgment and bad decisions, the rest of society should not be expected to chip in.

So for New Jersey residents, the effects of the ACA caused even more rate increases and the implementation of huge deductibles. Worse, the ACA and its accompanying thousands of pages of regulations, written by bureaucrats and not medical and business professionals, have imposed drastic limitations on coverage even for people who paid extra for better medical insurance.

I have been in the medical insurance business for over 50 years. Prior to 2012 when the first of the costly changes brought by the ACA took effect, we did not have one non-New Jersey client where family coverage cost more than $800 per month. In 2012, we saw small non-New Jersey employers with increases as high as 80 percent – in just one year. How many small employers partnering with their employees can afford $20,000 per year per family in medical premiums? A great deal of that money has disappeared after use by the federal government in unknown ways.

Our family has a current matter where Obamacare forced a hospital to make decisions that were dangerous and unacceptable to the patient, her physicians, our family and to our insurance companies. Had we not brought all guns to bear here, the outcome likely would have been far worse.

I do not disagree that there were issues with medical coverage prior to the imposition of the ACA. However, the ACA has ended up costing a huge amount of money for, on net, very small changes. Accessibility, even when the public fails to uphold their responsibilities to maintain coverage to protect the risk pools, has seen no gains here in New Jersey.

J. Lindsay Fuller
Moorestown, N.J., and Beach Haven

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