August 15, 2001

Department of Human Services Acting Commissioner James W. Smith announced today a two-pronged approach to making sure the popular NJ FamilyCare health insurance program reaches its goal of insuring as many low- and moderate-income families as possible while continuing to stay within its budget.

"We are proud of all that NJFamilyCare has accomplished since it was first introduced as NJKidCare in 1998," said Acting Commissioner Smith. "This program now provides health insurance for almost 200,000 adults and children who previously were uninsured. The actions being announced today will strengthen our ability to continue to enroll children and their parents in the program in the months ahead."

Among the actions are a new marketing effort to enroll more children and placing some limits on enrollment and benefits for adults without children as of Sept. 1, 2001.

Smith said that a new $1.5 million marketing effort kicked off this month with the goal of increasing awareness of the program among children and their families. A particular target of this effort is children with family incomes between 200 and 350 percent of the federal poverty level, or for example, children who are from families of four with annual incomes of $35,300 to $61,775. The marketing effort will include mailings, assembly programs in 200 elementary schools, informational advertising spots on Nickelodeon TV and a joint effort in southern New Jersey with Pennsylvania and Delaware in conjunction with the McDonald's Corporation.

In addition to the new marketing effort, Smith said that effective on Sept. 1, some low-income childless adults will no longer be able to enroll in the program. Parents with family incomes up to 200 percent of the federal poverty level and Work First/General Assistance recipients will continue to be able to enroll in the program.

The following changes take effect on September 1:

Single adults and childless couples who are not eligible for WorkFirst/General Assistance (GA) and whose applications are received after Sept.1 will no longer be able to enroll in the program. That means childless couples earning more than $2600 per year, or approximately 30 percent of the Federal Poverty Level, will no longer be eligible. These adults will continue to be able to apply for hospital Charity Care and are guaranteed access to hospital emergency rooms by federal law. Until now, childless adults with an income up to 100 percent of the Federal Poverty Level, or $8,590 for one person and $11,610 for a couple, have been eligible for the program.

Single adults and childless couples whose applications are received prior to Sept. 1 and who are found eligible for the program after Sept. 1, will not receive services until they are enrolled in a health maintenance organization (HMO). This will end the practice of providing services on a fee-for-service basis pending enrollment in a managed care plan. Work First/General Assistance beneficiaries will continue to be enrolled in the program. After Sept.1, however, hospital coverage will only begin once the individual is enrolled in an HMO. This will end the practice of providing hospital coverage to GA beneficiaries on a fee-for-service basis pending enrollment in a managed care plan. (WorkFirst/General Assistance is a cash assistance program for single adults and childless couples who are disabled or unemployed and earn less than $50 a week. These beneficiaries receive other basic health insurance benefits as part of their Work First/General Assistance benefit package until they are enrolled in a NJ FamilyCare HMO. They also are eligible for coverage under the hospital charity care program pending enrollment in a NJ FamilyCare HMO.) Currently, 123,000 adults are enrolled in NJ FamilyCare. This number includes about 24,000 GA beneficiaries, 13,000 childless adults and 85,000 parents. Between 1,000 and 2,000 adults, most of them parents, are continuing to enroll in the program each week and adult enrollment on Sept. 1 is expected to reach about 129,000.

NJ FamilyCare, which receives matching funds from the federal government to insure children and parents, is expected to cost a total of $490 million in the 2002 fiscal year. This includes $370 million to insure adults and $120 million to insure children. In the Fiscal Year 2002 budget, the Legislature appropriated an additional $25 million for the program and also gave the Commissioner of the Department of Human Services authority to make any changes deemed appropriate to keep the program within its budget.

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