Betsy Ryan is president and CEO of the New Jersey Hospital Association. Her blog, Healthcare Matters, examines the many issues confronting New Jersey's hospitals and their patients. Readers are encouraged to join the discussion, because healthcare matters - to all of us.

Supreme Court Ruling Brings Great Relief to New Jersey’s Newly Insured

The U.S. Supreme Court’s action today in King v. Burwell is a wonderful decision, and a great source of relief, for the nearly 200,000 New Jersey residents who would have faced losing their health insurance. Whether you like or loathe the Affordable Care Act, we’re at a point in its implementation that we’re seeing some real impact – real benefits – for healthcare consumers who now enjoy greater access to the healthcare services they need. To have backtracked on that progress would have been devastating for those individuals. It also would have been a big blow to the hospitals and other healthcare providers that take care of those patients regardless of their ability to pay, and would have introduced a great deal of uncertainty throughout the insurance marketplace. I’m thrilled that we can continue with our efforts to improve our healthcare delivery system and strive to make quality, affordable healthcare accessible to all. 

Written by Betsy Ryan at 00:00

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ACA Onlookers Hold Their Breath for Another Supreme Court Ruling

Two years ago, we all waited anxiously to see if the U.S. Supreme Court would uphold the constitutionality of the Affordable Care Act. The Supremes (as I like to call them) did uphold the law – but here we are again in 2015, waiting for another Court decision that could be historic in determining the law’s fate.

In King v. Burwell, the challenge involves one section of the 1,000-plus-page law dealing with the IRS, and it will determine if states that chose to use the federal government’s Web site to enroll people can offer those enrollees a federal subsidy to help pay for the insurance. New Jersey was among 37 states that chose not to establish their own exchange and instead rely on the “federal exchange.”

Most people agree that this was a drafting error in the law, but the Supreme Court will issue a decision within the next month that could determine if 203,473 New Jerseyans (out of 254,316 total enrolled on may continue to receive federal funding to offset the cost of the premium. This represents 83 percent of those enrolled in New Jersey. The Supreme Court decision could have a monumental impact on the ability of these individuals to afford health insurance.

The ACA evokes strong feelings in many, but no one can deny it has reduced the number of uninsured Americans in our country by about 11 million. It would be a shame to take a step backward and see that number creep back up.  I remain optimistic that the Supreme Court will view the law in its totality, listen to those that worked on the legislation and rule that the subsidies may continue to flow regardless of what type of exchange an individual used to enroll. Why should a New Yorker receive a subsidy but a New Jerseyan be denied, simply because of a technicality in where their exchange was rooted? It just doesn’t make sense.

Time will tell – about 30 days’ time to be precise, with the Court’s current session slated to wrap up at the end of June.

Written by Betsy Ryan at 00:00

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Hospitals Provide Lessons in Managing Change

My son is graduating from the 8th grade and will enter high school next fall. It’s a major change in our household, and frankly, he’s handling it much better than I am.  It’s made me think about change in general, and how difficult change can be for people. Now, consider something as complex as our healthcare system. In that scenario, change becomes an enormous challenge.

But here we are nevertheless, with our healthcare system in the midst of historic change. Much of it is driven by the Affordable Care Act, and some of it is driven by the changing demands of consumers and the growing pressures in the healthcare marketplace. Whether you love or loathe the ACA, virtually all economists and healthcare policy experts agree that change was needed to redesign our healthcare system and ensure its sustainability into the future.

In a nutshell, the changes we seek are: Improved quality of care. Healthier communities. Lower healthcare costs. It’s a pretty simple formula, but achieving it is not simple at all.

For those viewing this change from the outside, some of the differences you’ll see are a growing transition from inpatient care in a hospital to more outpatient care (part of the shift to less costly settings.) Or you’ll see hospitals working in cooperation with physician practices to coordinate care and share data regarding patient care (a move toward greater efficiency.) Or – as we’ve experienced a great deal in New Jersey – you’ll see hospitals merging and affiliating with other hospitals. That promotes sharing of resources and services, gives hospitals access to more capital and gives communities greater access to services that may not always be available from a single hospital.

What’s not as visible behind the scenes is the hard work going on within our hospitals and health systems to adjust to these changing times. Taking care of our communities 24/7/365 is difficult enough without these added pressures of monumental change. I am very impressed with the leadership within our hospitals and health systems and the unwavering focus of their staffs. With one eye on the future, they continue the daily responsibility of caring for their patients. For someone struggling with change, I think I can learn something from their excellent example.

Written by Betsy Ryan at 00:00

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NJHA Brings in the Reinforcements for ACA Enrollment Woes

The Health Insurance Marketplace at has had a rough launch, no doubt about it. Fixes to the site are supposed to be in place by the end of the month, but clearly the impact has already been felt in the disappointing early enrollment figures. While the Obama Administration had aimed for 500,000 enrollees in the first month, the actual tally was a mere 106,000. We need to do better in insuring more Americans.

Here in New Jersey, we’re calling in reinforcements. On Monday, Veterans Day, NJHA officially announced its new effort to hire 25 U.S. veterans to serve as Certified Application Counselors and assist N.J. residents in enrolling for new coverage options under Medicaid, NJ FamilyCare and the Health Insurance Marketplace. Our first team of CACs have been hired, trained, certified and are already working in the field answering questions and assisting individuals. They’re prepared to assist in enrollment via paper form, telephone or online. Having met several of these veterans, I can tell you that they are up to the task – they are committed, determined, goal-oriented, service-minded problem solvers. They are the right men and women for the job. As the daughter of a Navy Seabee, the sister of a Navy Seabee, the wife of a Naval Officer and the sister-in-law of two Marines, I am proud to play just a small part in this program.

If you’re struggling with your options under the Affordable Care Act, our platoon is ready to assist. We’re in the process of scheduling our teams of CACs in healthcare facilities and other locations across the state. Additional information and a schedule of enrollment events can be found on the Get Help page of our Healthcare Reform Resource Center  at We’ll be updating it regularly as additional events are scheduled throughout the year, so check back often for a location near you.

Written by Betsy Ryan at 00:00

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Rest Assured. Get Insured.

No one likes to get sick, but for more than 1 million New Jersey residents, illness brings a much greater worry. They are New Jersey’s uninsured – individuals and families without health insurance coverage. For them, the lack of health insurance is a major obstacle to accessing preventive care or a simple doctor’s appointment. As a result, a minor illness often becomes a major health concern that can threaten both their physical and financial well-being.

Oct. 1 is an important day for these folks. It marks the opening of the Health Insurance Marketplace, a key part of the Affordable Care Act that aims to ensure millions more Americans.

Whatever your political leanings, Obamacare is here and it’s entering a critical phase. Few could argue against the benefits of health insurance – for both healthcare consumers and for the future of our healthcare delivery system. We urge all uninsured New Jersey residents to explore their options in the Health Insurance Marketplace at or Subsidies and tax credits are available to eligible individuals and families to help make coverage more affordable. Additional information and assistance is available around the clock by calling 1-800-318-2596.

Health insurance provides better access to healthcare services and delivers financial peace of mind. Help you and your loves ones rest assured: Get insured.

Written by Betsy Ryan at 00:00

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