State Sen. Joe Vitale, a Democrat and a leading voice in healthcare policy in the Legislature, was the featured speaker at an April 7 New Jersey Chamber of Commerce Roundtable Breakfast.

He was straight to the point: Replacing the federal Affordable Care Act, he said, "would be a disaster for New Jersey" because it would reduce funding for Medicaid, reduce health services, lower payments to hospitals, and push up the cost of state-funded charity care.

In New Jersey, "we would have to cut services and enrollment," he told business leaders at the National Conference Center in East Windsor. Repeal and replace lost last month, he added, "but it will come back."

Meanwhile, Vitale said the state must take steps to prevent surprise billing by out-of-network health care providers and to regulate telemedicine. In addition, he said it would be wrong for the state to raid Horizon Blue Cross Blue Shield's reserve fund to pay for state-budgeted drug treatment. He cautioned that allowing health insurance policies for people from a patchwork of states, known as "across state lines," might lower premiums but would water down medical coverage.

Out-of-Network Surprise Bills

Vitale said patients in New Jersey have been hit with expensive bills charged by out-of-network healthcare providers even when they go to hospitals that are in their insurance policies' networks. "It's egregious and awful to someone who has to pay," Vitale said. It has long been a problem in New Jersey and efforts to address it have been delayed. "There is legislation that contemplates how to get insurance companies and healthcare providers together (to end) this."

Telemedicine - Health Care by Phone

Vitale said he hopes New Jersey passes legislation (S291) that will regulate the practice of people in New Jersey accessing doctors by phone or Skype without having to first see a primary health care provider. "Telemedicine offers healthcare access to urban and suburban residents," he said. "I'm hopeful we'll move that forward."

Horizon Blue Cross Blue Shield's Reserve Fund

Sen. Vitale opposes Gov. Christie's proposal to take money from Horizon's reserve fund to help pay for drug treatment. "In a way, that demonizes what Horizon does," Vitale said. "It's not a sustainable source and it's not the right thing to do."

Across State Lines

Vitale said insurance policies that cover people in regions that transcend state lines don't always result in good insurance coverage. "We are blessed (in New Jersey) with strong consumer protections and requirements," Vitale said. "To offer care with states that don't have the same consumer protections can lead to less expensive policies that don't cover much. That doesn't help us."

Thank you to Trinitas Regional Medical Center for sponsoring the event.