In Congress: Post Independence Day Recess

After adjourning abruptly on June 23 due to the Democratic protest on the House floor over gun control, the House returns to legislative business on Tuesday, with votes expected on 16 bills under suspension of the rules. Included in this suspension package is H.R. 5210, the Patient Access to Durable Medical Equipment Act, sponsored by Rep. Tom Price, R-Ga., bipartisan legislation to preserve patient access to durable medical equipment (DME) after severe cuts to Medicare DME payment rates were scheduled to take effect on July 1, 2016. If allowed to take effect, these cuts are expected to have a negative effect on patients’ access to DME, particularly in rural areas. Other measures to be considered under suspension of the rules include seven bills reported by the Natural Resources Committee, three bills reported out of the Financial Services Committee, and three reported out of the Foreign Affairs Committee.

The House:

On Wednesday, the House is expected to turn to consideration of H.R. 2646, the Helping Families in Mental Health Crisis Act. This legislation, proposed by Rep. Tim Murphy, R-Pa., and reported by the Energy and Commerce Committee, would reform the nation’s mental health system by focusing programs and resources on psychiatric care for patients and families most in need of services. The bill when introduced sparked partisan disagreement, but the sponsor and committee leaders worked to bridge those disagreements, and the bill as revised was reported unanimously by the committee last month, demonstrating its broad and bipartisan support. The potential that the bill could provoke further debate over gun rights and gun control during floor consideration (Energy and Commerce Committee Democrats attempted unsuccessfully to attach gun control amendments to the legislation during the committee markup, but H.R. 2646) is likely what led House leaders to bring the bill up under suspension of the rules, which precludes amendments during floor debate. The Senate Health, Education, Labor and Pensions Committee has been working on its own version of mental health legislation. Press reports indicate that key senators involved in the issue are seeking to attach the Senate version of the bill to the conference report on the opioid-abuse legislation, the Comprehensive Addiction and Recovery Act, passed in differing versions by both chambers and scheduled for consideration by a conference committee on Wednesday of this week. Either way, the broad recognition that the nation’s mental health system is in deep crisis could produce a legislative success before Congress adjourns this year, although funding issues may prompt Democrats to oppose a final bill if it does not include increased resources.

Also on Wednesday, the House is expected to take up H.R. 5611, the Homeland Security and Safety Act, sponsored by House Majority Leader Kevin McCarthy. The so-called “anti-terrorism” package would establish within the Department of Homeland Security a new “Office for Partnerships to Prevent Terrorism” to assist with the prevention of violent extremism and radicalization associated with terrorists and terror networks. The new legislation also contains a provision related to gun control. In the wake of the Democrats’ demands and the apparent shift in public opinion on the issue following the San Bernardino and Orlando shootings, the bill includes a provision that would allow the attorney general to delay for three days the sale of a gun to either an individual on the terrorist watch list or an individual who has been investigated for terrorism during the past five years, and prohibit the sale of a firearm if there is sufficient evidence that the purchaser poses a credible threat to homeland security. The language is reportedly based on a proposal authored by Sen. John Cornyn, R-Texas, in the Senate, which would also give the Justice Department 72 hours to delay the sale of a gun to any suspected terrorist on the watch list. The proposal failed to achieve the necessary support for passage in the Senate due to Democratic opposition, and House Democrats have already denounced its inclusion in the House anti-terrorism package as not doing enough to keep guns out of the hands of terrorists. Despite the likely Democratic opposition to the bill, the inclusion of the provision, which is not likely to become law, is a marked step forward for gun control advocates and may portend limited success for them in the next Congress. Consideration of H.R. 5611 will be subject to a rule.

It remains to be seen whether House Democrats will again employ protest tactics on the House floor over gun control as they did during the week of June 23, or how they will attempt to amend the Homeland Security and Safety Act during floor consideration this week. House leadership will be working to maintain order on the House floor in order to continue functioning effectively and proceed on legislative business prior to the summer recess.

Additional items that may be considered in the House this week include H.R. 1270, the Restoring Access to Medication Act, reported out of the Ways and Means Committee. This legislation would allow for disbursements from health savings accounts, medical savings accounts, and health flexible spending arrangements for over-the-counter drugs. Current rules under the Affordable Care Act only allow these disbursements for the purchase of prescription drugs and insulin. Also pending a floor vote this week is H.R. 4361, the Federal Information Systems Safeguards Act of 2016, legislation to restrict federal employee access to personal accounts on platforms such as Facebook and Gmail at work in order to provide greater security for government information technology and systems. The legislation clarifies that federal agencies have the sole and exclusive authority to take appropriate and timely actions to secure their information technology and information systems. Among its provisions is one clearly barring access to pornographic or explicit materials from a government IT system. Consideration of both measures will be subject to a rule.

Finally, the House may also consider H.R. 5845, the FY 2017 Financial Services and General Government Appropriations Act, after postponing its consideration following the Democratic sit-in on the House floor in June. The $21.7 billion funding bill provides appropriations for the Treasury Department, the Judiciary, the Small Business Administration, the Securities and Exchange Commission, and other agencies. As discussed in a previous column, the Financial Services and General Government spending measure is considered one of the more controversial of the 12 annual appropriations bills because of policy riders that are opposed by most Democrats and the administration. Consideration of the Financial Services and General Government Appropriations Act for FY 2017 will be subject to the same structured rule process that governed consideration of the defense spending bill last month in order to avoid votes on controversial amendments.

The Senate:

The Senate resumes legislative business on Wednesday, when a vote is expected on a district court nominee. Senate Majority Leader Mitch McConnell, R-Ky., filed cloture on proceeding to four bills at the end of last week. Votes are expected on these cloture motions this week. Among these four measures are two pieces of legislation related to so-called “sanctuary cities,” which are those communities that have policies in place declining to assist or actively defying federal immigration laws and orders. These communities have been a focus of Republicans for many years and a hot-button issue on the presidential campaign trail, particularly since the fatal shooting of a San Francisco woman over the Fourth of July holiday in 2015 by a person in the country illegally after having been deported from the U.S. five times. The first cloture vote will be on a motion to proceed to S. 3100, the Stop Dangerous Sanctuary Cities Act, sponsored by Sen. Pat Toomey, R-Pa. This bill would limit federal funding to cities that do not comply with federal immigration law. The second vote scheduled in the Senate is cloture on the motion to proceed to S. 2193, a measure sponsored by Sen. Ted Cruz, R-Texas. This bill would increase mandatory minimum prison sentences for undocumented immigrants who repeatedly enter the United States illegally. The Senate voted on similar proposals last October when they were coupled together as a single piece of legislation, but the bill failed to pass. Both measures are subject to a 60-vote threshold for consideration on Wednesday, and neither is expected to garner the necessary support due to Democratic opposition.

If these first two motions on sanctuary cities are defeated, Leader McConnell has also lined up a cloture vote on a bipartisan bill sponsored by Senate Agriculture Committee Chairman Pat Roberts, R-Kan., and Ranking Member Debbie Stabenow, D-Mich., that would establish a national guideline for the labeling of foods with genetically modified organisms. While the proposal under consideration has bipartisan support and is the product of careful and lengthy negotiations, some strong opposition to the bill remains, including that of Sen. Bernie Sanders, I-Vt., whose home state passed its own strict GMO labeling mandate in 2014 that went into effect on July 1, 2016. Several industry groups, which argue there is no scientific evidence that GMOs are harmful and prefer a single federal labeling standard over a patchwork of state laws, have sued to block the Vermont law and the litigation is currently pending. Should the Roberts-Stabenow measure pass, it would preempt and nullify the Vermont law and create a federal standard for the packaging of GMO foods. The cloture motion must achieve the 60-vote threshold in order to limit debate on the bill. The House has already passed a bill on GMO-labeling, but whether it would accept the Senate bill or insist on its stronger bill is not yet clear. Ultimately, the issue is of such importance to the food industry that if the Senate bill passes, as is likely, the House can be expected to accept it as well, perhaps even before the start of the summer recess.

The final item in the queue is a vote on cloture on the motion to proceed to the FY 2017 Department of Defense appropriations bill, also subject to a 60-vote threshold, which is expected to pass. The funding measure, advanced unanimously by the Senate Appropriations Committee, provides over $515 billion for the Pentagon base budget and $58.6 billion for Overseas Contingency Operations (OCO) for the upcoming fiscal year. The legislation does not shift OCO funding for base budget increases, a procedure the House Appropriations Committee pursued in its bill for FY 2017, which makes the bill more satisfactory for Senate Democrats to provide their support. The Senate is likely to continue its consideration of the Defense Appropriations bill into next week.

Leader McConnell has indicated there will also be another opportunity for Senators to take up the House-passed FY 2017 Military Construction and Veterans Affairs appropriations conference report, which also serves as the vehicle to provide funding to combat the Zika virus. The Senate attempted a vote prior to the Fourth of July recess, but Senate Democrats blocked its consideration over the Zika funding restrictions and offsets, and called for a new negotiation on the legislation. Senate leadership has rejected the demands for a renegotiated proposal, indicating that the current House-passed proposal is the only means of moving forward before the upcoming recess. Leader McConnell has not yet scheduled the vote on the conference report.

Even with the shortened week due to the Independence Day holiday, there is an active hearing schedule on both sides of Capitol complex.

As mentioned above, the conference committee charged with negotiating opioid abuse legislation is scheduled to meet on Wednesday. One of the major remaining hang-ups to the bill involves funding for programs that are authorized in the legislation. Democrats argue that the authorization bill is ineffective without providing the necessary appropriations and that emergency funding should be allocated; Republicans oppose emergency funding that would likely not be offset and argue that funds should be provided through the annual appropriations process.

The House Appropriations Committee is getting closer to completing its work on the 12 annual appropriations bills for FY 2017. The State and Foreign Operations Subcommittee is scheduled to mark up its bill on Wednesday morning while the Labor, Health and Human Services, and Education Subcommittee meets on Thursday morning to mark up its bill. The full committee is likely to consider both bills next week.

Two House hearings scheduled this week will be focused on the Affordable Care Act cost-sharing reduction program. The House Ways and Means Subcommittee on Oversight meets on Thursday morning to discuss the program, while the full Energy and Commerce Committee will meet on Friday morning.

The Senate Homeland Security and Government Affairs Permanent Subcommittee on Investigations will be meeting on Wednesday afternoon to discuss the threat posed by online recruitment by ISIS and other terror networks. Representatives from the FBI, Department of Homeland Security and Department of State are among the witnesses that will provide testimony before the subcommittee.

Also on Wednesday afternoon, the House Judiciary Subcommittee on Regulatory Reform will hold a hearing on President Obama’s regulatory impact on the U.S. economy.

The Joint Committee on Taxation will hear from Treasury Department representatives on Wednesday regarding the administration’s proposed regulations under Internal Revenue Code section 385 to combat inversion transactions, those in which U.S. businesses merge with foreign firms and move their headquarters overseas to lower their tax rate. The Treasury Department issued the proposal in April. The proposal has drawn criticism from many domestic and multinational businesses, and members of both parties have joined in the criticism that the proposal sweeps too broadly and will capture many innocent transactions, thereby depressing domestic economic activity and job creation. Treasury Assistant Secretary for Tax Policy Mark Mazur and Deputy Assistant Secretary for International Tax Affairs Robert Stack are scheduled to appear before the joint committee.

A joint subcommittee hearing by the Committee on Foreign Affairs’ Subcommittee on Asia and the Pacific and the Committee on Armed Services’ Subcommittee on Seapower and Projection Forces is scheduled for Tuesday afternoon regarding maritime disputes in the South China Sea. Representatives from the Departments of Defense and State will provide testimony on the escalating territorial disputes between China and its neighbors in Southeast Asia.

 

 

New Jersey State Assembly members hear testimony on Horizon’s Omnia Alliance

New Jersey State Assembly members heard testimony today on Horizon’s Omnia Alliance and its controversial tiered healthcare plans that face legal challenges from an eleven-member coalition of hospitals who say they are being strong-armed into an unfavorable deal with Horizon Blue Cross. The mayors of Trenton (Eric Jackson) and Elizabeth (Chris Bollwage) criticized the provider at the joint hearing of the Assembly Health and Services and Regulatory Oversight Committees.

Critics say hospitals that did not agree to reimbursement rates favorable to Horizon in exchange for higher patient volume have been forced to charge high rates to disadvantaged customers as second-tier institutions, setting the stage for losses in inner-city areas as those hospitals decline or fail. Proponents cite a need for drastic cost reductions in New Jersey, and say Horizon is merely executing a strategy that many smaller providers have already put in place. Horizon insures nearly 50% of patients across New Jersey.

Representatives of Horizon and the acting DOBI Commissioner were not present at Wednesday’s hearing.

Jackson and Bollwage said that the new Omnia plans have already placed an undue burden on poor and inner-city communities.

“What damage has been done in the meantime?” asked Jackson. “Not only to the institutions, but how many lives have been impacted by individuals who not only have a $4,500 deductible but find out when they get to a tier two physician, or hospital, that their copays are more than double what they saw on that sheet?”

Jackson said that he was testifying in the interest of defending Trenton’s charity, faith-based and non-profit hospitals from unfavorable public perceptions as well as new fiscal challenges.

“We are a tier-one city all the way around,” he said.

“Healthcare hospitals are the economic engines for your communities, and sometimes even the largest employers next to the cities,” said Shavonda Sumter (D-35), of Paterson, thanking the mayors for bringing the economic impact of the tiered networks into the discussion.

Saying that the new plans were “designed to shift market share from disfavored tier-two hospitals to favored tier-one hospitals in a non-transparent and secretive manner,” former Department of Banking and Insurance Commissioner and attorney Steven Goldman painted the approval process from the New Jersey DOBI as too hasty.

“No input was sought from any of the tier-two hospitals that I represent,” Goldman said, adding that a thorough review would have taken months and not the two weeks Horizon waited before it received approval.

Health and Senior Services Chair Herb Conaway (D-7) agreed with the mayors’ testimony that many patients in low-income areas with a low density of tier-one hospitals would have to travel over an hour for care.

“It doesn’t really fully appreciate the transportation challenges that many people have,” said Conaway. “And we’re going to have to address that in regulations.”

Regulatory Oversight Chair Reed Gusciora (D-15) criticized the marketing push for the Omnia plans as obfuscating the cost and failing to address access, saying of Horizon’s materials “It doesn’t say ‘oh by the way, if you live in Trenton or Elizabeth don’t bother with these plans.”

At one point, Gusciora held up a spreadsheet detailing Horizon’s Omnia plan options for public workers, putting to Jackson and Bollwage that the second-tier providers have to levy exorbitant patient copays.

“One of them is the Horizon OMNIA, and it notes that it has the tier one and tier two program. If you choose a tier two hospital you have to pay a $4,500 copay. And I was wondering, how many of your constituents, per visit, can afford $4,500?” he asked Bollwage.

“I can’t,” Bollwage answered. “I’m a Horizon member and if you said to me I have to pay another $4,500, that’s going to take something out of the budget in my own household.”

 

 

Out-of-network legislation clears Assembly committee

The New Jersey state Assembly bills to address surprise out-of-network hospital bills are one step closer to becoming law, despite some remaining concerns for both payers and providers.

The two bills, sponsored by Assembly Democrats Craig Coughlin (D-Woodbridge), Gary S. Schaer (D-Passaic), Troy Singleton (D-Mount Laurel), Pamela Lampitt (D-Voorhees) and Grace Spencer (D-Newark), cleared the Financial Institutions and Insurance Committee on Monday.

Originally introduced earlier this year as a single bill, the two new pieces of legislation cover changes in the administrative process for hospitals during non-emergency procedures, as well as creating a new transparency tool to determine what providers are charging for care — known as the Health Price Index. If enacted, the out-of-network bill would rely on the state Department of Banking and Insurance to find an organization to collect and maintain the Health Price Index.

The out-of-network bill, which is similar to a bill making its way through the Senate, is raising concerns about the increased burden on health care professionals, while the creation of a new price tool is likely to increase the already too-high-cost of insurance plans.

The New Jersey Business and Industry Association supported the out-of-network bill, but has some concerns about the HPI.

“NJBIA continues to oppose creation of an HPI,” testified Mary Beaumont, vice president for health and legal affairs.  “Surcharges on health insurers and benefits plans will ultimately increase health care costs for New Jersey employers. Furthermore, it’s duplicative. Existing sources collect and provide in-network and out-of-network cost information from physicians, hospitals, health care facilities and insurers.”

Similar opposition can also be seen for the administrative burden on doctors from the out-of-network bill.

But the bills’ sponsor believes the physicians and health care professionals within the health system should be responsible for tracking the insurance information. Laws already exist for emergency situations to be treated as in-network, so elective procedures are typically where surprise bills appear.

“If they were given the choice between continuing with medical care that ultimately would lead to substantial out-of-pocket costs and considering other options that carry a lower price tag, the vast majority of reasonable New Jersey residents certainly would choose the latter. The problem, at present, is that they don’t have that choice,” said Schaer.

Sen. Joseph Vitale, who heads the health committee and reviewed a similar bill, applauded the Assembly bill.

“Along with my Assembly counterparts sponsoring the bill, I am now confident that we have a piece of legislation that will advance through both houses before the end of this legislative session,” Vitale (D-Woodbridge) said in a statement. “People are being forced to choose between paying off medical bills that they never expected to receive or paying their necessary everyday expenses like rent, mortgage and food. It’s not a fair choice to have to make. New Jersey consumers need to know what they’re getting into, before non-emergent out-of-network medical services are provided, so they can make informed choices rather than being arm-wrestled into damaging debt.”

The bills call for the following to be implemented by health care facilities:

  • Disclose whether the facility is in- or out-of-network.
  • Advise the patient to check with the doctor arranging the services to determine whether or not the doctor is in- or out-of-network.
  • Advise the patient if a change in network status has occurred between the time the appointment was made and the time of the procedure.
  • Advise that the patient contact his or her insurance carrier for further consultation regarding costs.
  • Make publicly available a list of standard charges for the items and services it provides
  • Follow a binding arbitration process to allow consumers a chance to fight surprise bills
  • Publish online the names, mailing addresses and telephone numbers of physicians working at the facility and hospital-based physician groups with which it has contracted to provide services, including anesthesiology, pathology and radiology.

The New Jersey Association of Health Plans released a statement supporting various aspects of the bill, but stated concerns with the peer review process, cost sharing for emergency services and the $1,000 threshold for arbitration — all of which were urged by hospitals and health care providers.

“We believe that the peer review process will add cost and prove to be of limited utility, as it is not likely to provide information not already available to the disputing parties.  We are also concerned about our experience with peer-review process, as we have seen that providers are reluctant to challenge their peers.  As a result, we do not support the proposal,” NJAHP said in the statement.

“While we continue to have concerns about a number of elements of the bill, especially the network audit section, which we see as redundant of existing regulatory requirements, overall, we are supportive of the bill.  Consumers, labor organizations, businesses, the State Health Benefits Program and other payers will benefit from the bill’s transparency measures and cost containment measures. It is time to put a stop to surprise bills for consumers and reign in the predatory price gouging practices by certain provider.”

Martin J. Milita, Jr. Esq., is senior director at Duane Morris Government Strategies, LLC.

Duane Morris Government Strategies (DMGS) supports the growth of organizations, companies, communities and economies through a suite of government and business consulting services. The firm offers a range of government relations and public affairs services, including lobbying, grant writing; development finance consulting, media relations management, grassroots campaigning and community outreach. Milita works at the firm’s Trenton and Newark New Jersey offices.

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NJ Out-of-Network Consumer Protection Act

The “Out-of-Network Consumer Protection, Transparency, Cost Containment, and Accountability Act.” [(Senator Joseph Vitale (D-19), Assemblyman Gary Schaer (D-36), Assemblyman Troy Singleton (D-7), and Assemblyman Graig Coughlin (D-19)] would implement sweeping legislation to reform various aspects of the New Jersey health care delivery system by: increasing transparency in pricing for health care services; enhancing consumer protections; creating an arbitration system to resolve certain health billing disputes; containing rising costs associated with out-of-network healthcare services; and, measuring success accordingly.

The  legislation would enhance employee rights and protections as patients and save an estimated $1.0 billion according to the sponsors. Others, including the New Jersey Association of Counties, (NJAC) are concerned that the measure may initially increase the costs of health benefits plans as the bill would impose an annual surcharge on all plans to fund operation and administrative expenses of a Healthcare Price Index (HPI). In summary, the HPI would: identify and electronically publish the list of median in-network paid commercial claims for the payment range as established under the bill; and, make healthcare data available to the State to improve healthcare quality, reduce healthcare costs, and increase pricing transparency.  Although in general it appears that the bill does directly apply to counties enrolled in the State Health Benefits Plan (Atlantic, Camden, Gloucester, Hudson, Mercer, Ocean, Salem, Sussex, and Warren), the annual surcharge imposed by the legislation would in fact impact all health benefit plans and counties.

Hence several recommendations have been put forth:  1) use an existing federal database on medical care to eliminate the need for a New Jersey specific HPI and corresponding surcharge; or, 2) establish  a New Jersey specific HPI as called for under the bill, but eliminate the surcharge, allocate a one-time State appropriation to establish the Health Price Index Fund, and dedicate monies collected from violations of the Act to the Fund for operation and administrative expenses.  NJAC is further seeking a clarification on whether the surcharge would impact health benefit plan expenses under the looming “Cadillac Tax” for high-cost employer-sponsored health benefits coverage set to begin 2018 at $10,200 for individual coverage and $27,500.000 for all other coverage tiers.

Bipartisan House Vote Passes Permanent Medicare ‘Doc Fix’

The U.S. House of Representatives on Thursday passed a bill intended to put in place a permanent “doc fix” to replace Medicare’s unpopular physician reimbursement system, commonly overridden by lawmakers each year.

H.R. 2, the Medicare Access and CHIP Reauthorization Act, passed in a 392-37 vote, with many Democratic lawmakers joining the bulk of House Republicans in supporting the bill after several lawmakers from each party spoke in favor of the legislation on the House floor Thursday.

Under the bill, Medicare’s current sustainable growth rate formula, or SGR, would be permanently repealed. Instead, Medicare doctor pay would rise by 0.5 percent each year between 2015 and 2019, beginning in July.

Payments will then be held at the 2019 rate through 2025, but physicians and other health professionals will be eligible for merit-based bonus payments based on factors such as meaningful usage of electronic health record systems and their use of care models that emphasize quality over volume.

From 2026 onward, medical professionals who use certain alternative payment systems will receive a 1 percent annual increase in their Medicare payment rates, with others seeing 0.5 percent annual increases.

The SGR is a measure meant to tie increases in Medicare reimbursements to inflation, designed to avoid runaway cost increases. But the formula has been routinely overridden for almost two decades, through enactment of an annual “doc fix” — usually at the last minute — with lawmakers generally arguing that keeping to the SGR rates would cause many doctors to refuse Medicare patients, threatening access to care for seniors.

Over time, the gap between the specified rate under the SGR and the actual Medicare payment rate has grown amid this long pattern of temporary fixes. If a doc fix is not signed into law this year, doctors would see their Medicare reimbursement rate drop by 21 percent.

In addition to the doc fix section of the bill, the legislation also includes a collection of measures to both relax and strengthen various aspects of anti-fraud oversight under Medicare and would extend both the Children’s Health Insurance Program, or CHIP, and certain funding for community health centers for an additional two years.

To help offset the expected cost of the bill, pegged at more than $210 billion, House Democratic lawmakers agreed to a number of other Medicare changes, including tweaks to make supplemental Medigap plans less generous starting in 2020, and requiring certain high-income seniors to pay higher premiums for doctor and outpatient care and prescription drug coverage.

Their Democratic counterparts in the Senate have offered the bill qualified support, indicating they may push for a longer extension on CHIP funding and look to tweak some aspects of the legislation, such as the inclusion of the so-called Hyde Amendment  — used to bar federal funds from being used to fund abortion — for community health center funding, the same clause that has seen an otherwise uncontroversial anti-sex trafficking bill stall.

The White House has indicated it will support the bill in its current form, backing up President Barack Obama’s measured support with a policy statement Wednesday saying it believed the reforms in the bill were “sensible.”

Christie budget statement and charity care for hospitals

The charity care funds that hospitals use to defray the cost of caring for indigent and uninsured patients are being reduced by $148 million, to $502 million, in Gov. Chris Christie’s fiscal 2016 budget. However, the administration said it expects New Jersey’s successful Medicaid expansion under the Affordable Care Act to ease the demand for hospitals to provide uncompensated care.

In its budget statement, the Christie administration said 390,000 low-income New Jersey residents have enrolled in the state’s Medicaid program, known as NJ Family Care, since the ACA-funded nationwide Medicaid expansion began Jan. 1, 2014. According to state figures, there are now 1.67 million New Jerseyans enrolled in NJ FamilyCare, which is funded by both state and federal tax dollars.

The Christie Administration budget statement said: “As widely anticipated, Gov. Christie’s decision to expand NJ FamilyCare under the ACA has led to a dramatic increase in federally supported NJ FamilyCare enrollment, as well as a steep reduction in New Jersey hospitals’ documented claims for uncompensated care.”

Betsy Ryan, chief executive of the New Jersey Hospital Association, said the hospitals are now assessing the impact of the 22.8 percent charity care funding cut.

Ryan applauded Christie for increasing funds to the state’s teaching hospitals to train physician residents: Christie’s 2016 budget increases funding for graduate medical education from $100 million this year to $127.3 million in fiscal 2016, which begins July 1, 2015.

More details on the impact of the charity care cuts will be forthcoming once the state Department of Health announces how much charity care individual hospitals will receive in 2016.