Let’s cut through the noise. What does the “big beautiful bill” have to do with my healthcare?

The “big beautiful bill” (or BBB) is a budget bill – and it wasn’t always so big. It used to be several smaller bills and proposals that Congress squished together. 

This is part of the reason why you’re hearing so many different things about the BBB. It’s huge, with different parts that relate to a lot of different programs. Since it’s a budget bill, it’s an outline of everything the federal government aims to spend money on, and how much, over the next year.

Part of that covers healthcare: Medicaid, insurance you buy on the NJ Family Cares or Get Covered marketplace, hospital funding, and funding for addiction and mental health treatment. There are parts in the BBB that address all of these things.

What does this have to do with my healthcare?

Let’s start with Medicaid, otherwise known as NJ Family Care. New Jersey needs around $24.3 billion to keep Medicaid functioning as they are now. Usually, the state of New Jersey would only need to cover part of that with our own budget – the federal government pays for the rest, around $14.9 billion of it.

Here’s a snapshot of what New Jersey uses that funding for:

• Medicaid covers 1.8 million New Jersey residents who are disabled, poor and elderly.
• Medicaid covers 60% of all nursing home beds and 40% of the state’s births.
• 45% of people enrolled in New Jersey’s Medicaid program are children.

So, what would the BBB change? The short answer is that it would reduce the amount that New Jersey receives by $3.6 billion — nearly a quarter of that $14.9 million in federal funding that we were supposed to get. These funds and the programs they pay for will be significantly reduced. 

New Jersey would need to cover the difference, but the Commissioner of the New Jersey Department of Human Services, as well as the Commissioner of the New Jersey Department of Children and Families, testified that “there is simply no way our state budget can absorb the magnitude of losses that are being proposed.”

It’s not just Medicaid. The BBB will also make changes to healthcare that we purchase through the New Jersey marketplace.

A lot of the talk around this bill has been about Medicaid, but it will also affect families who buy their insurance through our state marketplace. You might know this as Get Covered NJ. 

Costs for this coverage went down for a lot of us in 2021 when premium tax credits for health insurance were made more widely available. I know “premium tax credit” isn’t the most glamorous-sounding term, but these credits decreased the amount we pay out of our own wallets for insurance premiums. 

The BBB would end these tax credits and shorten the time period where people can enroll before they lose the chance to buy health insurance for the year. Because of this, 88% of those enrolled via Get Covered NJ, or more than 450,000, would face price hikes averaging 110% annually.

New Jerseyans approaching the age when they are eligible for Medicare would see the largest cost increases – in other words, older people. Older New Jerseyans may pay an average of $1,860 more each year if tax credits expire. Here are some more detailed facts and figures from Get Covered NJ:

You can check out a breakdown of how many people in your county will lose coverage here. We pulled out the stats for Congressional District 2 in South Jersey, since many of us live in this district, and our Representative, Congressman Van Drew, voted “yes” to the BBB:

If you put together the changes made to both Medicaid and Medicare, and marketplace insurance, this would eliminate coverage for at least 360,000 New Jersey residents.

It would also cut as much as $300 million in hospital aid. 

Members of Congress say this is to cut down on waste, fraud, and abuse. Congressmen Kean, Van Drew, and Smith say that these changes to Medicaid, marketplace insurance, and healthcare aren’t cuts – they’re reforms to improve these programs. We’ve been meeting with them over the past few months and have relationships with some of them going back years. 

We would love to see a crackdown on waste, fraud, and abuse, because it definitely does happen. In 2019, federal prosecutors in West Virginia accused Acadia, the country’s largest and wealthiest chain of methadone clinics, of overbilling Medicaid for blood and urine tests. The company paid $17 million to resolve the allegations, so imagine how much more they actually defrauded Medicaid for. 

Most of the fraud committed against Medicaid is actually committed by big providers like these, not patients, since they are the ones that receive Medicaid payments. The substance use treatment industry in New Jersey is often caught red-handed charging for services they didn’t adequately provide. 

But if this is the case, why do these changes put the healthcare of everyday people like us on the line? That’s what we’re trying to figure out – and what we’re trying to ask our Representatives to consider.

This isn’t a party politics thing. Here in Ocean County, where a quarter of all residents are enrolled in some form of Medicaid, our all-Republican Board of Commissioners voiced their opposition to harmful changes to Medicaid in May.

Commissioner Frank Sadeghi said this issue transcended partisan politics, and stated, “I’ve been watching this, this is wrong. I don’t care if it’s being sponsored by Republicans. It’s wrong for Ocean County.”

We want to stand up for our healthcare here in New Jersey. If you do too, join us.