WASHINGTON, D.C.U.S. Senators Bob Menendez (D-N.J.) and Bob Casey (D-Penn.) both members of the Senate Finance Committee that sets national health policy, and Senator Cory Booker (D-N.J.) today introduced the State Allowance for a Variety of Exchanges (SAVE) Act that would provide $200 million in competitive federal grant funding to support states like New Jersey and Pennsylvania in establishing their own state-based health exchanges. Moving from the Trump-run federal marketplace system would give states flexibility to expand coverage options, increase enrollment, and lower health costs for consumers.

“The Trump Administration will continue doing everything they can to destroy the Affordable Care Act, and along with it, the health care coverage millions of families rely on,” said Sen. Menendez. “While we keep fighting them back, this bill empowers states like ours to protect the strides we’ve made, expand health insurance coverage to more New Jerseyans, increase options, and bring down the costs of care overall.”

“The data show that state-based health exchanges have a greater ability to enroll more people for coverage than the federal exchange, and allow greater flexibility to tailor plans based on the needs of their populations,” said Sen. Casey. “In order to help states transition to state-based health exchanges, we have introduced the State Allowance for a Variety of Exchanges Act, known as SAVE, to offer grant funding to states to set up their own state-based health exchanges. This legislation will help states to manage customer assistance, control user fees and set enrollment periods, which will help strengthen the Affordable Care Act and ensure that the people of Pennsylvania have access to affordable health insurance options.”

“As the Trump Administration continues to sabotage the Affordable Care Act, states like New Jersey have no choice but to establish their own state-based health exchanges to reduce uncertainty and costs for many,” said Sen. Booker. “This bill will not only help New Jersey as it establishes a state-based health exchange, but it will also help any other state looking to move away from the Trump-run federal marketplace and put the health care needs of its residents first.”

States like New Jersey, operating on the federal exchange, have been subject to the Trump Administration’s tactics to undermine their enrollment efforts, including cutting 90% funds for advertising and reducing the open enrollment period from three months to six weeks. Earlier this year, New Jersey’s Governor Phil Murphy announced that the state would launch its own health insurance exchange.

“In New Jersey, we have taken the steps to give our residents the peace of mind that the options afforded them by the Affordable Care Act will be protected under state law, despite efforts by the Trump Administration to sabotage those options,” said New Jersey Governor Phil Murphy. “It is long past time to give all Americans the comfort of knowing their health care is not under threat. I applaud Senator Menendez, Senator Booker and Senator Casey for leading the way to establish a pathway for every state to develop their own state-based exchange, protecting the great strides we have made to provide affordable, quality health care in New Jersey and beyond.”

The New Jersey Hospital Association, in a letter to Senator Menendez from its President and CEO, fully endorsed the legislation, writing: “On behalf of this diverse group of stakeholders, I want to express our appreciation to you for your efforts to build upon the successes of the Affordable Care Act and for taking steps to ensure that health care remains accessible and affordable for everyone in New Jersey.”

A recent report by the nonpartisan National Academy for State Health Policy shows that state-based exchanges are proven to have higher enrollment growth, which has been shown to further bring down costs.

Specifically, the State Allowance for a Variety of Exchanges (SAVE) Act:

  • Authorizes $200 million in competitive federal grant funding to help alleviate a state’s financial burden during the transition from a federal to a state-based health exchange.

    • To access this money, states may submit applications to HHS detailing their implementation plans.
  • State-based exchanges allow greater local control, flexibility and freedom to regulate plans, allowing states to offer options tailored to their population’s needs.
  • States can also control factors like length of enrollment period, consumer assistance, user fees, plan options & actuarial projections, which help with stabilization efforts.
  • States have a greater ability to attract people to sign up for coverage via targeted advertising, which leads to a more balanced risk pool, expanded coverage options and lower overall healthcare costs.

A recent report show that states running their own exchanges outperformed states on the federal exchange in attracting consumers to sign up for health plans in 2018.

Enrollment rose among eight of the 12 state-based exchanges and three of the five states that run their own exchanges, but rely on the federal HealthCare.gov computer system.

In contrast, 2018 sign-ups increased in just five of the 34 states that are part of the federal exchange.

The Federal exchange website user fee has doubled since 2017 from 1.5% to 3%. State-based health exchanges can decide their own premium assessments based on the needs of their market instead of sending those funds to the federal government.

According to the Commonwealth Fund, states with state-based exchanges had an average premium of $526, while states with federally-facilitated exchanges had an average premium of $633.

The bill text can be viewed here.

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