A plan from New Jersey’s largest health insurer to divide hospitals into a two-tiered system has caused significant division among stakeholders and local lawmakers.
Horizon Blue Cross Blue Shield of New Jersey’s Omnia plan provides two choices for consumers: a lower-cost option for patients using “tier one” hospitals, and higher premiums for those electing to patronize “tier two” providers. The product was rolled out in September 2015, and has generated significant criticism from healthcare providers who say the insurer has not been transparent in the standards it used to create the tiered networks.
New Jersey Senate President Stephen Sweeney has defended Horizon’s plan, declaring that tiered health policies are needed to lower healthcare costs in the state, whose residents already pay the second-highest premiums in the country.
His comments are in direct opposition of a group of seven legislators who say they want to freeze enrollment into the Omnia plan until Horizon has disclosed how hospitals are placed in either tier.
Several bills have been drafted in response to the Omnia plan, one of which proposes to create a 21-member task force to study the issue. That particular bill was approved by the Assembly Regulatory Oversight committee.
Sweeney’s comments came in a Senate Commerce committee hearing in which he stopped short of endorsing the plan, but asked that debate be more focused on consumers, rather than hospitals and insurers.
“We should not advance any measures that ultimately threaten consumer choice in he marketplace and drive up costs,” Sweeney said. “Too many times, there is a tendency in this building to respond to the groups that bang their pots and pans the loudest.
“We cannot lose sight of our true constituency The New Jersey consumer.”
The debate over the Omnia plan has crossed party lines as legislators continue to debate over the impact the plan has on low-income patients and the hospitals that provide them with care.
