Fred Mogul, Reporter, WNYC News
Fred Mogul has been covering healthcare and medicine for WNYC since 2002.
Now that the Supreme Court has upheld the Obama administration’s signature health care reform law, Gov. Chris Christie is weighing options for the state on the bill’s biggest provisions: creation of a health exchange and expansion of Medicaid.
Gov. Christie said he is not sure that New Jersey needs to expand Medicaid under the federal health care law because the state's program that covers the poor and disabled is already so inclusive.
“Medicaid is already pretty well expanded in our state, due to the legacy of previous Democratic governors, so I don't think there's a lot to do in that respect,” Christie said while appearing on Fox News Channel’s "Fox and Friends" show, one of four national television appearances he made Tuesday, a day after he told New Jersey lawmakers during a special session that they should cut taxes.
In New Jersey, people with children are eligible for subsidized health coverage even if they make up to 350 percent of the poverty rate — or nearly $81,000 for a family of four.
There are various programs that serve childless adults with different income limits. But for those who are not pregnant, blind or disabled, participants must make less than the poverty level.
According to the Rutgers’ Center for State Health Policy, the proposed expansion of Medicaid eligibility would give coverage to 264,000 New Jersey residents, and an insurance exchange would add 180,000.
Under the Affordable Care Act, the federal government would pay for 90 percent of the Medicaid expansion, and states would pay 10 percent. The Supreme Court last week ruled that Washington can't withdraw all support for Medicaid if states decline to accept the new guidelines.
On CNBC's "Squawk Box," Christie said that the Obama administration should give more Medicaid money to the state with no strings attached, rather than specifying that each state should expand eligibility to the same level in each state.
"What works in New Jersey, I suspect, would be very different from Montana," Christie said.
Christie added he is exploring the idea of the federal government setting up a state health insurance exchange required under ACA, enabling individuals to buy insurance.
Christie said choosing between a Trenton-based or Washington-based health insurance exchange would come down to which costs less for New Jersey.
“I don’t want to spend any money that I don’t have to spend from state taxpayer dollars,” Christie said. “The fact of the matter is, if it's more cost-effective to let the federal government set this up, we may go that route on the health exchanges. You do have the two options.”
The state legislature passed a bill creating a health exchange in the state. Christie vetoed it, saying the state should wait until the Supreme Court ruled on the constitutionality of the Affordable Care Act.