Speaker Prieto, Hudson County Elected Officials Raise Concerns regarding Horizon OMNIA Tiered Insurance Plan

Insurance plan’s fairness to vulnerable urban populations at issue

(JERSEY CITY) — Assembly Speaker Vincent Prieto was joined by many of Hudson County’s elected leaders Tuesday in raising questions and concerns regarding Horizon Blue Cross Blue Shield of New Jersey’s plan to create a so-called “Tiered” hospital insurance system.

The officials expressed concern that the OMNIA plan announced by the state’s largest private insurance carrier could create an uneven playing field and could lead to higher costs and fewer care options for patients in urban areas, potentially even leading to hospital closures.

“There are many questions that need to be answered regarding this plan,” said Speaker Prieto. “We all recognize the urgent need to curtail growing health care costs and to adapt to changes in health care delivery, but at the same time we must be mindful of what these changes mean to the individual patients and to community hospitals, especially in urban areas where many residents do not have the means to travel to far away to receive care.”

Elected officials who appeared at the press conference included Jersey City Mayor Steven Fulop, Congressman Albio Sires, North Bergen Mayor and State Senator Nick Sacco, State Senator Sandra Cunningham, Hudson County Executive Tom DeGise, Bayonne Mayor Jimmy Davis, West New York Mayor Felix Roque, Weehawken Mayor Richard Turner, Guttenberg Mayor Gerald Drasheff, Hudson County Freeholder Chairman E. Junior Maldonado, Freeholders Anthony Romano, Anthony Vainieri and Gerry Balmir, Sheriff Frank Schillari, County Clerk Barbara Netchert, County Register Pam Gardner, Assembly candidates Nick Chiaravalloti, Angela McKnight and Annette Chaparro.

“We’re very concerned that this plan predetermines which health care providers will succeed and which ones will fail — and that it’s setting up many of the providers in Hudson County for failure,” said Mayor Fulop. “Worst case scenario, this could create entire communities in Hudson County where there is a lack of quality care. And we want to work with Horizon to make sure that does not happen.”

Horizon’s plan, which many of the attendees only found out about from news reports, is drawing widespread skepticism from many elected officials from throughout New Jersey. The Senate Health and Commerce committees have announced that they will hold a joint hearing on the plan in the coming weeks.

“For thousands of residents in North Hudson this plan could mean that they would not be able to use our local hospital in Palisades Medical Center without paying much higher out-of-pocket costs,” said Mayor Sacco. “That would have a terrible impact on our community, potentially undoing decades of hard work in building a top flight hospital right in our backyard. I would hope to see this proposal changed to include more urban hospitals or shelved altogether rather than proceed as is.”

Of Hudson County’s six hospitals, only Jersey City Medical Center would be considered a “Tier 1” hospital under the OMNIA Plan where patients could see cost reductions. All five other local hospitals, including Jersey City’s Christ Hospital where the press conference was held, could see patient loss as Horizon policy-holders are incentivized to seek non-emergency care elsewhere.

“The evidence is absolutely clear that people in urban areas need community hospitals,” said County Executive DeGise. “I would hate to see a major insurance carrier like this being in the business of picking winners and losers, rather than focusing on what their core mission should be — providing affordable coverage to their customers.”

Additional speakers at the event included Senator Cunningham, who stressed the importance of Christ Hospital to Jersey City, as well as Congressman Sires who reflected on the successful fight to pass the Affordable Care Act and the disappointing effects the plan could have even after that tremendous success. Freeholder Romano also spoke about the key importance of Hoboken University Medical Center to the Mile Square City and the long fight to keep the hospital open after it nearly closed a few years ago.