Issues in Health Care Reform: Interview Summary

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Health care reform passage is a significant aspect of the political work of states’ governors because their decisions build the voters’ trust and influence the population’s prosperity. New Jersey’s Governor Phil Murphy established programs for local clinics and enhanced the efficiency of the Affordable Care Act (ACA) use for expanding the access to medical services for diverse categories of citizens (Phil Murphy, n. d.). Programs such as allowing the clinics to get the Accountable Care Organization status help the state’s facilities to accelerate the quality of treatment; however, many of the novelties are unaffordable for the population.

My experience as an AGNP revealed that many patients suffer from severe and chronic conditions that could be prevented if they could pay for advanced health care on time. Improving the affordability of services through reforms is essential in New Jersey, and Murphy’s attention to addressing the issue would significantly impact the state’s health-related rates (Terrizi et al., 2021). One such legislative update is the state-based health exchange for the year 2021, announced by the governor in 2019 to protect the ACA’s power in insurance operations (State of New Jersey, 2020). Murphy’s campaigns addressed the demand for expanding the affordability of health care services by optimizing the industry’s taxpayers’ expenses. This paper aims to summarize and analyze the interview with New Jersey governor about the State-Based Health Exchange reform under the ACA.

Health policy issues must be addressed from the organization’s and government’s perspectives, and the ACA’s update for the State-Based Health Exchange is the regulation to which Murphy paid significant attention. The industries are being funded both publicly and privately, and although it allows the organizations to improve their services, it severely impacts treatment costs. Furthermore, New Jersey’s governor pointed out that private insurance providers develop fraud schemes that make basic healthcare expensive for the average citizen. The number of such cases increased during Trump’s administration as the ACA regulations received less support from the national Department of Health and Human Services (State of New Jersey, 2020). The threat of insurance-based fraud in the health care services providence enabled Murphy to eliminate the issue by establishing the state-based health exchange regulation. The reform redirected the assessment of premiums to localize the exchange rather than maintain it federally facilitated, making the funds more efficient for the residents (Managed Care Executive Staff, 2021). The governor also mentioned that the reform’s beneficiaries were mainly the Medicaid program participants.

Affordability of health care is a significant challenge for most American states because of the diverse populations’ socioeconomic statuses and financial options. New Jersey’s citizens’ survey conducted in 2020 revealed that “more than three-fourths (77%) adults reported being “worried” or “very worried” about affording some aspect of healthcare in the future” (Altarum, 2020). The ACA was developed and passed by Barack Obama to increase access to medical services, and the state’s governor’s mission was to help the regulations consolidate. Consequently, passing the state-based health exchange regulation became an evidence-based solution supported by the local administration (Managed Care Executive Staff, 2021). Murphy had to discuss the issues of changing the fees’ exchange with the federal facilities; however, the governor received positive feedback because the health care industry’s problems are of high priority (Phil Murphy, n. d.). The policy update was passed in 2019, and now it helps New Jersey address the COVID-19 pandemic, which became a massive burden on the state’s health care institutions.

Establishing the State-Based Health Exchange results in additional autonomy in decision-making related to expenses for insurance coverage, making it affordable for more New Jersey residents. Murphy explained that when the state was involved in the federally-facilitated programs, the individualized health insurance market was unstable, and the bureaucratic procedures made it complicated to timely address the issues (State of New Jersey, 2020). Indeed, the federal-based health exchange programs provide the states with fewer options to operate within their insurance opportunities and make costs inappropriate for the residents of specific populations. Furthermore, Terrizi et al. (2021) claim that “states with state-based marketplaces have seen higher Medicaid enrollment when compared to states relying on the federal marketplace.” Murphy’s opinion regarding the need for the state-based health exchange in New Jersey proved itself once the COVID-19 pandemic began and forced the administration to fund the health care sector.

Conversation with the governor included a discussion of the outcomes and trade-offs associated with the health care reforms passed during Murphy’s administration. Murphy noted that more than 250 thousand New Jersey residents enrolled to receive the insurance since the reform’s policies passage, making health care affordable for a broader scope of the population statewide (State of New Jersey, 2020). The administration’s trade-offs for passing the reforming policies were related to the demand for becoming a state eligible to switch from the federal-based exchange. Furthermore, Murphy explained that ACA-developing campaigns are supported mainly by Democrats rather than the Republicans, and additional negotiations were necessary (Sances & Clinton, 2019). The outcomes for private insurance providers with political power had been discussed before the passage and included a further legislative revision to identify how the stakeholders’ rights and obligations would update.

The citizens and news outlets discuss the effectiveness of the administration’s measures applied to address the COVID-19 pandemic’s outbreak, and the intensely negative opinions exist, influencing the governor’s authority. In response, Murphy mentioned the importance of priorities set and emphasized that the challenge is complicated to address due to the novel nature of the disease. Indeed, fighting against the virus that caused the country to lose more residents than during the wars enabled the administration to select strategies that would not destroy the economy and still be efficient for health care providers (Sances & Clinton, 2019). Furthermore, the governor has recently announced the plans to allocate $700 million in state taxpayer money and federal coronavirus relief funds on the projects that address the health care institutions’ issues (Johnson, 2021). The investment was approved in May and could be less significant if New Jersey was still the federal-based health exchange regulation (Johnson, 2021). Consequently, Murphy suggested that the health care reforms passed by the administration before the COVID-19 outbreak provide additional help to address the severest disease challenge.

The governor’s role in selecting and passing the health care reforms is significant, and the decisions made in the administration influence the daily life and well-being of every citizen. During the times of the COVID-19 pandemic, populations are especially concerned about their insurance and the affordability of medical services. Phil Murphy, New Jersey’s governor, discussed how the reform towards switching from the federal-based exchange to the state-based one benefited the residents and provided the state with additional funding to address the current challenges. Health care reforms were passed to support the ACA regulations and take the insurance market under the local government’s control.

References

Altarum. (2020). New Jersey residents struggle to afford high healthcare costs; COVID fears add to support for a range of government solutions across party lines. Web.

Johnson, B. (2021). Murphy plans to spend $700M on COVID recovery and more. Top Republican blasts the proposal as ‘grossly incomplete.’ NJ.com. Web.

Managed Care Executive Staff (2021). States are saying bye to HealthCare.gov and setting up their own ACA exchanges.Managed Care Executive. Web.

Phil Murphy. (n. d.). Health care. Web.

Sances, M. W., & Clinton, J. D. (2019). Who participated in the ACA? Gains in insurance coverage by political partisanship. Journal of Health Politics, Policy and Law, 44(3), 349-379. Web.

State of New Jersey. (2020). Governor Murphy announces launch of new state-based health insurance marketplace, Get Covered New Jersey. Web.

Terrizi, S., Mathews-Schultz, A. L., & Deegan, M. (2021). State versus federal health insurance marketplaces: A bigger deal for Medicaid and a smaller deal for the individual mandate. Health Policy OPEN, 100059. Web.

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Issues in Health Care Reform: Interview Summary

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