We should let the state’s largest insurer get into the health care business | Opinion

By John F. McKeon Health care itself and what the public rightfully demands – from how care is provided to the technologies that make care more convenient – has changed dramatically in a COVID-19 world. Moreover, health care costs and spending continue to rise, making it more difficult for New […]

By John F. McKeon

Health care itself and what the public rightfully demands – from how care is provided to the technologies that make care more convenient – has changed dramatically in a COVID-19 world. Moreover, health care costs and spending continue to rise, making it more difficult for New Jerseyans to get the care they need. Part of meeting that demand means updating laws that were created long before we even imagined many of the changes we see now.

That is why this week I introduced legislation that would allow Horizon Blue Cross Blue Shield of New Jersey – the state’s largest not-for-profit health insurer – to do what it plans to do or has already done in 18 other states: modernize its corporate structure to become a not-for-profit mutual company.

Horizon, as it is currently set up, faces restrictions that for-profit and out-of-state health insurers do not face. This puts Horizon’s members at a disadvantage when it comes to the pace and scale of innovations needed to improve quality and affordability. For example, Horizon is more limited than out-of-state health insurers when it comes to the amount of money it can invest in businesses or technologies – including even those that are working to get us through the pandemic – that can benefit the consumer.

In a state where we spend more on health care than the national average and at a time where we need as much innovation as possible, can we afford – literally and figuratively – to limit the amount of health care options insurers are able to provide?

Through this bill, seniors and underserved communities will have greater access to things like telemedicine. Clearly, this is of the utmost importance during the pandemic, especially for these communities. Moreover, allowing Horizon to invest even more in programs means they will have an even greater ability to go directly into communities and connect customers with these kinds of services.

If you are currently a customer of Horizon, you will not see any disruption in your service as a result of this change. That is true regardless of the kind of plan you have. If you like your current health care plan, nothing will change there either. The goal is to provide more – and better – options to consumers.

This corporate form is common in the insurance sector. New Jersey would not be making a dramatic change here. On the contrary, it is playing catch up with the 18 other states that have already seen the benefit of doing this. Just as importantly, this change would preserve Horizon’s unique and historic mission as a not-for-profit insurer that exists for the benefit of the members it serves.

When I introduced similar legislation last year, several issues were raised by those in the health care community. We have spent the last year working on those issues while still providing the kind of change needed to give Horizon more and better options. The bill I introduced last week addresses all of the concerns that were raised.

First and foremost, Horizon will remain a not-for-profit health insurer. In fact, my legislation explicitly prohibits them from converting to a for-profit. Any claims to the contrary are simply not true. Second, rather than create a new law that could have unintended consequences, we are amending the old law as many advocates requested. Horizon will remain a charitable and benevolent health insurer and it will still be responsible to its members, not to any stockholders.

Now that these concerns have all been addressed we need to move forward because this legislation is about more than Horizon: it is about the people it serves. It is about addressing consumer demands for creating more affordable health care options and increasing the quality of those options for 3.6 million New Jerseyans.

I look forward to working with my colleagues to ensure this legislation passes and that we create more, not fewer, choices for quality health care in New Jersey.

Assemblyman John F. McKeon represents the 27th Legislative District, which includes parts of Essex and Morris counties.

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