Operating Status

The director of the Center for State Health Policy at Rutgers discusses the state’s initiative to increase access to health care

Rutgers is working with the state to implement a new law that will provide universal health care coverage to nearly 90,000 children in New Jersey, including those who are undocumented.

The state became the seventh in the nation last month to create universal health care insurance coverage for children when Gov. Phil Murphy signed a bill that eliminates waiting periods and premiums for most families. The law, informed by analysis of Census data by the Center for State Health Policy at the Rutgers Institute for Health, Health Care Policy and Aging Research, expands children’s access to New Jersey Medicaid, also known as the NJ FamilyCare program.

Joel C. Cantor, director of the Center for State Health Policy and distinguished professor of public policy at Rutgers, who has led efforts to inform health care policy in New Jersey, discusses what comes next and why creating this new opportunity for coverage  is so important.

What does the law do?
The law eliminates a 90-day waiting period for some children to access NJ FamilyCare and ends the use of premiums for families who earn less than 350 percent of the federal poverty level or less than $6,400 a month for a family of three; premiums will still apply for higher-income families. This overcomes a major barrier for families of limited means to enrolling their kids for medical coverage. In addition, it revives  the FamilyCare Advantage program, which allows families who earn more than 350 percent of the poverty level to purchase this state coverage for their children at cost.

The law makes a significant state investment in the wellbeing of children in New Jersey by removing  barriers to enrollment in NJ FamilyCare, andcreating a pathway for those  who are not eligible under federal rules due to immigration status.

What did the Center’s analysis find?
The Center described the uninsured child population to inform the policy strategies to cover all kids. We discovered that before the pandemic about 4 percent—88,305—of New Jersey children did not have health insurance. Of these uninsured children, about 44 percent are Hispanic and 15 percent are Black, non-Hispanic. Nearly three-quarters of uninsured children are U.S. citizens, but 21 percent of citizen children have at least one non-citizen parent.

We also found that 78 percent of these children have income levels that make them eligible for NJ FamilyCare.  Kids meeting income-related and other eligibility criteria can get coverage at no cost to families under the new law.

What is next?
The challenge now is designing effective public awareness outreach, enrollment and retention initiatives for NJ FamilyCare and the NJ FamilyCare Advantage buy-in programs. The new law calls on the center to assist in designing the updated application strategies.

Our analysis has identified the characteristics of families that are most likely to have uninsured children, but work needs to be done on reaching families that may be unaware of available coverage or might be reluctant to enroll. Our analysis also found that 63 percent of the uninsured live in a household where a language other than English is spoken, which is important to know for outreach.