Repository navigation
NJ Health Plan Savings: cite the 2026 documents for the 2026 claim #9515
New issue
Have a question about this project? Sign up for a free GitHub account to open an issue and contact its maintainers and the community.
By clicking “Sign up for GitHub”, you agree to our terms of service and privacy statement. We’ll occasionally send you account related emails.
Already on GitHub? Sign in to your account
base: main
Are you sure you want to change the base?
Changes from all commits
File filter
Filter by extension
Conversations
Jump to
Diff view
Diff view
There are no files selected for viewing
| Original file line number | Diff line number | Diff line change |
|---|---|---|
| @@ -0,0 +1 @@ | ||
| NJ Health Plan Savings: cite the DOBI FY2026-2027 budget response for the program's continuation to 600% FPL in plan year 2026 after the enhanced federal credits lapsed, and the Department's 2026-08-18 letter for the 2025 poverty-guideline vintage; correct the Treasury addendum page anchor. |
| Original file line number | Diff line number | Diff line change |
|---|---|---|
|
|
@@ -8,8 +8,10 @@ metadata: | |
| reference: | ||
| - title: Treasury Office of Tax Analysis Section 1332 methodology addendum, Table 2 (Enhanced subsidy schedule) | ||
| href: https://www.cms.gov/files/document/1332-ota-methodology-addendum-nj-pass-through.pdf#page=12 | ||
| - title: NJ DOBI FY2025-2026 Budget Discussion Points | ||
| - title: NJ DOBI FY2025-2026 Budget Discussion Points, p.8 ("lowest ... $20 and the maximum is $100") | ||
| href: https://pub.njleg.state.nj.us/publications/budget/governors-budget/2026/dobi_response_2026.pdf#page=8 | ||
| - title: NJ DOBI FY2026-2027 Budget Discussion Points, p.4 (schedule continued to 600% FPL in 2026; PY2025 cohort averages by FPL band) | ||
| href: https://pub.njleg.state.nj.us/publications/budget/governors-budget/2027/dobi_response_2027.pdf#page=4 | ||
|
Collaborator
There was a problem hiding this comment. Choose a reason for hiding this commentThe reason will be displayed to describe this comment to others. Learn more. Minor nit: the newly cited PY2025 income-band averages ($16/$43/$91/$96/$40) are on page 5. Page 4 supports the continuation to 600% FPL. Could you retain the page-4 reference for continuation and add a page-5 reference for the averages, updating the explanatory comment accordingly? |
||
| - title: P.L. 2020 c.61 | ||
| href: https://pub.njleg.gov/bills/2020/AL20/61_.HTM | ||
| - title: Get Covered NJ - New Jersey Health Plan Savings | ||
|
|
@@ -20,19 +22,27 @@ brackets: | |
| # CORROBORATION CHAIN: the exact per-member-per-month (PMPM) values below are | ||
| # the ENHANCED schedule (post-ARP, effective mid-2021) from the U.S. Treasury | ||
| # Office of Tax Analysis Section 1332 methodology addendum (Nov 2021). These | ||
| # values appear both as body-text bullets on file p.8 and, more cleanly, in the | ||
| # side-by-side Table 2 ("Enhanced" column) on file p.12 (the href points at | ||
| # Table 2). The enhanced schedule states: | ||
| # values appear both as body-text bullets on printed page 8 (PDF page 9) and, | ||
| # more cleanly, in the side-by-side Table 2 ("Enhanced" column) on PDF page 12 | ||
| # (the href points at Table 2). The enhanced schedule states: | ||
| # "From 138% through 150% of FPL: $20 PMPM"; "From 150% through 200%: $40 PMPM"; | ||
| # "From 200% through 250%: $50 PMPM"; "From 250% through 400%: $100 PMPM"; | ||
| # "From 400% through 600%: $50 PMPM". This is NOT the superseded INITIAL schedule | ||
| # (Feb 2021: $20/$30/$40/$95, covering only 138-400% FPL) printed in Table 1 on | ||
| # file p.5, which the model deliberately does not use. The DOBI FY2025-2026 | ||
| # Budget Discussion Points confirm the enhanced schedule remains unchanged/flat | ||
| # for PY2026 (NJHPS expenditures "projected to remain flat at $212.2" million in | ||
| # FY2026, continuing "up to 600% FPL"). Neither source alone both states the | ||
| # values and confirms PY2026 currency, so both are carried. The Get Covered NJ | ||
| # URL is a secondary (anchorless) corroborating reference, not a value source. | ||
| # file p.5, which the model deliberately does not use. No New Jersey document | ||
| # for plan year 2026 restates the five amounts (Get Covered NJ's page sends the | ||
| # reader to its calculator), so PY2026 currency rests on the DOBI budget | ||
| # responses: FY2025-2026, p.8 — "The lowest amount an eligible individual can | ||
| # receive per month in New Jersey Health Plan Savings is $20 and the maximum is | ||
| # $100", and "$100 per person per month – which can mean a $400 a month for a | ||
| # family of four at 300% FPL"; FY2026-2027, p.4 — the Department "continued | ||
| # providing NJ Health Plan Savings subsidies up to 600% FPL" after the enhanced | ||
| # federal credits lapsed, with PY2025 cohort averages ($16 under 200% FPL, $43 | ||
| # at 200-250%, $91 and $96 at 250-400%, $40 at 400%+) all at or under the | ||
| # schedule, as a premium-capped flat amount must be. Neither source alone both | ||
| # states the values and confirms PY2026 currency, so all are carried. The Get | ||
| # Covered NJ URL is a secondary (anchorless) corroborating reference, not a | ||
| # value source. | ||
| # Bands are lower-exclusive / upper-inclusive, so thresholds use the "x.0001" | ||
| # convention to match the published "from X% through Y%" banding. The 138% floor | ||
| # is enforced by the eligibility gate; this base band gives $0 below 138% FPL so | ||
|
|
||
There was a problem hiding this comment.
Choose a reason for hiding this comment
The reason will be displayed to describe this comment to others. Learn more.
Minor nit: the newly added $200.0M FY2027 expenditure projection and $0.0M closing balance are on page 11. Could you add that reference and update the comment/title to distinguish it from page 4, which supports the 2026 continuation and PY2025/PY2026 spending figures?