Lawmakers Question Method Used to Negotiate Plan with Only a Chosen Few Hospitals in the State
Stressing the need to protect “patients over profits,” Assemblyman Reed Gusciora, Assemblywoman Elizabeth Muoio, Trenton Mayor Eric Jackson and Mercer County Executive Brian Hughes on Thursday called on the NJ Department of Banking and Insurance to place a hold on an announced plan by Horizon Blue Cross Blue Shield (HBCBS) excluding certain urban hospitals, including both capital city hospitals, from premier insurance coverage.
According to HBCBS they will only provide select coverage for its insured at 22 state hospitals; leaving others with “higher premiums and deductibles” for those who utilize hospital services not designated as “Tier 1.”
“We are disappointed and concerned that Horizon took this unilateral action without any public airing or transparency,” said Gusciora (D-Mercer/Hunterdon). “If Horizon truly operates in the public interest it should go back to the drawing room and negotiate in good faith with all hospitals in the state, and not just a chosen few.”
“While this is an issue affecting residents across the state, we are greatly concerned about insured individuals in the capital city area having readily affordable access to quality health care,” said Muoio (D-Mercer/Hunterdon). “Horizon has left the two capital city hospitals on the cutting room floor. This will have a detrimental effect on the financial stability of the two largest non-governmental entities in the city.”
Joining the Assembly members was Trenton Mayor Eric Jackson, Mercer County Executive Brian Hughes and representatives of St. Francis Hospital and Capital Health Care.
“I am alarmed by the lack of transparency and communication in the creation of Horizon’s OMNIA Alliance,” said Mayor Jackson. “Horizon’s Tier 1 system excludes both St. Francis Medical Center and Capital Health, which would leave our residents without critical maternity and cardiac care. That is unacceptable.”
Gusciora, Muoio, Jackson and Hughes sent a letter to DOBI Acting Commissioner Richard Badolato today detailing their request. A full copy of the letter can be viewed here.