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State regulator warns federal rule, expiring tax credits could shrink Get Covered New Jersey enrollment
Summary
Commissioner Justin Zimmerman told the Senate Budget and Appropriations Committee that a proposed Centers for Medicare and Medicaid Services rule and the possible end of enhanced federal premium tax credits threaten New Jersey’s state-based health insurance marketplace, Get Covered New Jersey, and its recent enrollment gains.
Commissioner Justin Zimmerman, head of the New Jersey Department of Banking and Insurance, told the Senate Budget and Appropriations Committee on May 1 that federal policy changes could sharply reduce enrollment and affordability on the state’s health insurance exchange, Get Covered New Jersey.
Zimmerman said the department’s operational budget for fiscal year 2026 is $65,300,000 and stressed the marketplace’s recent growth: “Get Covered New Jersey's enrollment has grown exponentially since it launched in November of 2020. During the most recent open enrollment period, over half a million New Jerseyans signed up for health coverage, marking another record breaking year of historic enrollment.”
The nut of Zimmerman’s testimony was a twofold risk to that progress. First, he warned that enhanced premium tax credits made permanent by federal action in recent years will expire at the end of 2025 unless Congress extends them, which his department projects would cost New Jersey consumers roughly $500,000,000 in lost federal assistance and make coverage significantly more expensive for about 455,000 residents. “If Congress does not act, consumers on average will pay double what they are paying now for health insurance,” Zimmerman said.
Second, Zimmerman said a recent Centers for Medicare and Medicaid Services (CMS) rule proposal would force state-based exchanges to shorten their open enrollment period from New Jersey’s current three months to six weeks and could curtail special enrollment policies that have allowed certain low-income residents to enroll year-round. He said the department submitted formal comments to CMS outlining how the proposed changes would harm Get Covered New Jersey.
The department also highlighted other affordability tools that support stability in the individual market: a Section 1332 state innovation waiver extending a reinsurance program through 2028 that Zimmerman said lowers premiums by about 15%, and state subsidies called New Jersey Health Plan Savings that extend help up to 600% of the federal poverty level for 2025 plan year eligibility. Zimmerman told senators the federal pass-through funding supporting the waiver for the year was estimated at more than $555,000,000.
Zimmerman credited outreach and navigator expansion for boosting enrollment: the department invested $5,000,000 in navigators during the most recent open enrollment period and now funds 26 navigator organizations offering assistance in more than 10 languages, up from one navigator in 2019. He added that the state’s call center is staffed by New Jersey residents.
Discussion on the committee focused on whether the department and the legislature should plan for the potential loss of federal assistance and on the administrative flexibility that state-based exchanges use to extend enrollment and special enrollment periods. Zimmerman said the department and administration will continue advocacy and monitoring in Washington and promised to work with the legislature to protect coverage access.
Looking ahead, Zimmerman urged continued state and federal action to preserve the marketplace’s gains and the protections the state has layered on top of federal law. He closed by repeating that the department will keep pressuring federal policymakers and preparing for contingencies that could reduce access in the individual market.
