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Crowd–Out In NJ FamilyCare. Ann Clemency Kohler Deputy Commissioner New Jersey Department of Human Services August 29, 2007. NJ FamilyCare & Crowd-Out. Original crowd-out period at the inception of the program was 12 months. In January 1999, crowd-out was reduced to 6 months
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Crowd–Out In NJ FamilyCare Ann Clemency Kohler Deputy Commissioner New Jersey Department of Human Services August 29, 2007
NJ FamilyCare & Crowd-Out • Original crowd-out period at the inception of the program was 12 months. • In January 1999, crowd-out was reduced to 6 months • In November 2005, crowd-out was reduced to 3 months • Reducing crowd-out has not had a significant impact on enrollment
Crowd-Out Criteria • Applies only to SCHIP/NJFC not to the traditional Medicaid program • Exceptions: • Regardless of income, if prior coverage was lost through no fault of the family • Family’s income is less than 200% FPL & they are purchasing coverage from an individual plan or COBRA • Family’s income is between 201-350% FPL & COBRA has expired
Affect of Reduced Crowd-Out Period • In SFY, 388 applicants were found to have insurance in the 3 months prior to applying for NJFC…….just over 1/2% of applicants. • 1820 applicants were found to have health insurance at the time of the application…….3.2% of total applications
Changes to Crowd-Out • SCHIP Bills will not affect New Jersey crowd out policy • Recent CMS letter requiring 1 year crowd out “will cause havoc with our program and could jeopardize coverage for thousands of children.”