Governor Phil Murphy

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Governor Murphy Announces State to Assume Greater Control of ACA Marketplace in NJ

05/15/2018

TRENTON – Governor Phil Murphy today announced that the state will take over the plan management functions of the Affordable Care Act marketplace for the upcoming 2019 enrollment period, assuming greater control over the health exchange in New Jersey.

The Governor recently sent a letter notifying the Centers for Medicare & Medicaid Services that the Department of Banking and Insurance will perform the plan management functions of the marketplace and, therefore, review for compliance with the ACA and New Jersey law all plans to be sold on the health exchange in New Jersey for plan year 2019. The move continues the Murphy Administration’s commitment to the success of the Affordable Care Act. Governor Murphy in January signed an Executive Order directing all state agencies that interact with the public to provide information regarding enrollment in the ACA marketplace.

“At a time when President Trump is attempting to dismantle the Affordable Care Act, it is up to states to step up and protect access to affordable quality health coverage,” said Governor Murphy. “New Jersey is committed to increasing enrollment to ensure as many individuals are covered by health insurance as possible. My administration also believes it is critical that the insurance offered in the state contain all the protections required under New Jersey law and the Affordable Care Act. Assuming responsibility for managing the plans sold on the exchange is a vital step in this process.”

The Department of Banking and Insurance has the responsibility of reviewing health plans sold in the state to ensure compliance with state laws. It currently performs review functions for the individual and small group market. The Department also reviews and makes recommendations to CMS regarding certification of plans for sale on the exchange in New Jersey. Plan management by the state will officially transfer the review function to the department as the regulatory authority in the state.

“We are dedicated to making sure that residents have access to affordable, quality health coverage and that plans sold in our state comply with New Jersey law and the provisions of the Affordable Care Act,” said Department of Banking and Insurance Acting Commissioner Marlene Caride. “The Department has the knowledge and expertise to take over the oversight and management of plans offered for sale on the exchange, but I believe it also has a responsibility to do so on behalf of our residents.”

Carriers will submit plans this month to be offered for sale through the federal marketplace in New Jersey. All qualified health plans (QHP) application data will be submitted to the State using the SERFF system, which is currently used for various filings.

The enrollment period begins November 1, 2018.

The governor’s letter to CMS is attached.

Letter_to_CMS.pdf