* New Jersey's coverage of poor families with children will continue under Medicaid, but a new group -- childless adults -- will be added, if Governor Christie decides to go along with the law. The Supreme Court's decision took away the penalties for states that do not implement that part of the law, leaving more discretion to the states. New Jersey already meets the threshold set by the law when it comes to families with children. The state currently provides Medicaid coverage to 1 million people, or 11 percent of the population.
* The uninsured -- 1.3 million or 15 percent of the state's population -- have a few possibilities. The poorest -- single adults with less than $14,857 income a year, or couples earning less than $20,124 -- would qualify for Medicaid, if the governor agrees to its expansion. That would take care of about 300,000 people in 2014.
Most of the rest could shop for insurance on a newly created state health exchange, required under the law. The exchange would be available to single people whose incomes are as high as $44,680, or families with incomes as high as $92,200, based on the 2012 federal poverty level. Enrollment through the exchange is expected to grow from about 189,000 in 2014 to more than 500,000 after eight years.
Christie said after the Supreme Court ruling that he'll veto the state Legislature's effort to create an exchange. He has already done so once. It may not be known until after the November presidential election if he'll propose an alternative or allow the federal government to set one up, as the law provides.
The exchanges would provide plans that vary in price depending on the level of coverage. Those who buy through the exchange would be subsidized via tax credits, under the law. A few scenarios: A family of four earning $22,050 could be required to pay no more than $441 per year toward the $12,000 premium. A family of four earning about $88,000 would be required to pay $8,379 towards that same premium.
If the cost of insurance on the exchange is unaffordable, people would be exempt from buying insurance and paying penalties. The law sets the definition of "affordable" on a sliding scale.
Small businesses could also shop for insurance for their employees on the exchange.
But here's the catch, and the most hotly debated part of the law: If a business with more than 50 workers doesn't provide insurance to its employees, or if an individual who files federal income taxes doesn't buy coverage, the business or individual will have to pay a penalty. For businesses, the penalty is roughly $2,000 per employee. For the individual, it is $695 ($2,085 per family) or 2.5 percent of income, whichever is greater.
The White House projects that 1 percent of Americans who will be able to afford health insurance will choose not to buy it. The secretary of Health and Human Services could give hardship exemptions.
This penalty was at the crux of the Supreme Court's deliberations and the element that got the most media attention. Chief Justice John Roberts called this penalty a "tax" in his decision Thursday. Congress is within its constitutional powers to levy a tax, he said in upholding the law.
Opponents of health care reform, including Christie and Steve Lonegan, state director of Americans for Prosperity, a group associated with the Tea Party, have seized on his language. The law is a "massive tax on middle class Americans," Lonegan said Saturday, adding that the state's economy can ill afford the effect of the penalties on small businesses.
The additional costs of insuring their workers would simply be passed through to customers in the form of higher prices, say some business owners, such as Albert Manzo of The Brownstone catering venue in Paterson. Or, as Manzo suggested, it might make better business sense to pay the penalty.
Democrats, on the other hand, say the law has the opposite effect.
"People who have insurance are going to get a tax cut," said Rep. Frank Pallone, D-Monmouth, an architect of the reforms. "They're going to get coverage and pay less."
The law would eliminate the "freeloader tax" that every insured American pays in extra premiums for people who use the health care system but lack coverage, they say.
"They won't have to pay $1,000 extra in health care costs to cover the cost of people without insurance," said U.S. Sen. Bob Menendez. "Ninety-five percent of Americans will never be subject to any penalty at all," he added. "The remaining 5 percent who willingly choose not to have coverage and pin the cost on all of us, they're the only people subject to any tax."
Each side will press its message going into the November elections, the next acid test for health care reform in America.
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