NJ Spotlight editor in chief Lee Keough and reporters Chase Brush, Tom Johnson, John Mooney, John Reitmeyer and Lilo H. Stainton report on ways the new president might impact New Jersey.
To get an idea of what state leaders are considering when they look toward 2017, NJ Spotlight asked a number of them to talk about changes we might expect next year in the areas of:
- Environment and Energy
One obvious target of a Trump administration is the Affordable Care Act.
Ending the program requires 60 votes in the U.S. Senate — something some observers said is unlikely, since lawmakers will face opposition from those who gained access to care, as well as hospitals, drug companies, and insurance companies that also benefited from the 2014 law.
“The interest-group politics align toward keeping it,” said Joel Cantor, director of the Center for State Health Policy and a Rutgers professor, adding that insurance companies alone have spent “tens of millions” remaking their systems to adapt to the ACA. “I think we’re talking about a hypothetical that won’t happen.”
But Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute, isn’t so sure.
“I think it will happen,” Schwimmer told NJ Spotlight. “I think it is a campaign promise he will move on,” she said, urging the president-elect to move carefully. “They'll be hearing from all their constituents who previously were shut out of insurance coverage and having it literally change or save their lives.”
Some 20 million Americans gained coverage under the ACA, including more than 700,000 New Jersey residents. Coverage for the vast majority of these folks would disappear without the federal funding now in place, experts predicted.
“This means there will be a lot more uninsured people,” Schwimmer said, “and we would be back where we were before.” That means a market with few affordable plans, let alone coverage that is truly comprehensive.
“We would go back to a status quo that wasn’t that good,” Cantor agreed.
As an alternative to the ACA, Trump has suggested he would provide federal block grants for states to craft their own Medicaid programs, instead of the current system that is run by states but primarily funded and governed by a national program.
Cantor felt this is unlikely, since the concept is “loathed by governors on both sides of the [political] aisle,” who may like the idea of greater flexibility, but oppose the cap on federal dollars that would leave them responsible for a growing share of the costs for covering the sickest, most expensive patients.
Cantor told NJ Spotlight that he expects a more likely outcome is that Trump will tinker with administrative changes that impact some aspects of coverage, but leave the framework of the ACA intact.
But Schwimmer felt a shift to block grants could well happen, especially with the ongoing shift in government insurance plans from a focus on volume to one on outcomes and cost. “I think the most likely option is to bring it back to the states,” she said.
The result is likely to be a patchwork of policies nationwide and growing focus on controlling costs at the state level, Schwimmer explained, as they are forced to pick up more and more of the tab. “It’s risk shifting,” she said. “And it would also be a big hit to our state budget.”
Trump has hardly made education a defining issue in his run for the White House. But he has laid out some broad positions on some of the hot issues of the day in New Jersey and elsewhere, even if short on details.
For instance, he has only shown disdain for the federal role in public education as a whole, reviving a proposal dating back to former President Ronald Reagan to dismantle the federal Department of Education altogether.
Whether this is even feasible is a question, but the position certainly suggests lighter federal oversight may be on the way.
“That’s red meat for the GOP, but I don’t see it happening,” said Patrick McGuinn, associate professor at Drew University who closely follows federal education policy. “But I do see he will try to roll back some of the regulation that come out of the department.”
McGuinn pointed to areas such as the Obama administration’s backing of the Common Core State Standards, already somewhat scaled back in New Jersey, to more specific federal oversight of civil rights policy in schools.
“You’re seeing echoes of that with the Obama administration, and Trump has said there will be pullback,” he said.
At the same time, Trump has been supportive of school choice and charter schools in particular, an issue that the federal government has some influence on through funding and the bully pulpit.
But how much his position differs from Obama’s pro-charter position is yet to be seen.
A more profound influence on the state’s education policy could be Christie’s expected exit from New Jersey to take a position in the Trump administration.
Christie has made pubic school reform one of the centerpieces of his tenure. But will that agenda leave with the governor? Most immediately, Christie is pressing for a rewriting of the state’s school-funding system through his “Fairness Formula,” including an appeal to the state Supreme Court.
Supporters said they did not think that push would run out of steam without the governor leading the way, and in fact it could be a pivotal issue for Republicans in next year’s gubernatorial race.
“I think we have a number of good candidates that can run in 2017, but most importantly I think we have to run on that Fairness Formula,” said state Sen. Michael Doherty (R-Warren). “It brings everything together for the Republicans of why our property taxes are so high in our towns, and I think it gives Republicans an effective weapon to advocate against the status quo.”
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