Bill > A6064

Introduced Session

This bill establishes the State medical relief program (the program) in the Department of Human Services (the department) to provide certain NJ FamilyCare enrollees, disenrolled from NJ FamilyCare benefits because of new eligibility suppressing conditions in the federal "One Big Beautiful Bill Act (OBBBA)," with limited medical relief funds for qualifying medical services. "Qualifying medical services" are the following outpatient services: hospital emergency room, physician, and behavioral health services, and prescription drugs. Individuals eligible for the program are those who lose NJ FamilyCare benefits due to certain OBBBA provisions: community engagement (work) requirements, more frequent eligibility redeterminations, and discontinuation of Medicaid and Children's Health Insurance Program (CHIP) eligibility for certain "qualified immigrants." Medical relief benefits will be provided, in equal allotments to all eligible individuals, via an electronic benefits transfer (EBT) card, with which an eligible individual may purchase qualifying medical services from licensed medical providers who have registered with the department to participate in the program. The amount of an eligible individual's medical relief benefit for a 12-month period, subject to the availability of State funding, will be determined annually by the Commissioner of Human Services (the commissioner) and deposited on the individual's EBT card at the time of initial application approval, and at subsequent annual eligibility redeterminations. An eligible individual must reapply for the NJ FamilyCare program at each opportunity to do so, unless the eligible individual has been disenrolled from NJ FamilyCare due to the immigrant provisions of OBBBA. Medical relief benefits will remain available for 12 months, or until fully expended. Once an individual has exhausted the individual's medical relief benefits for a 12-month period, the individual may choose to self-pay for qualifying medical services from a participating provider, at a cost that equals the NJ FamilyCare rate for the identical service. The commissioner will automatically enroll individuals who lose NJ FamilyCare benefits under OBBBA in the program on a provisional basis, unless the individual affirmatively opts out. Provisionally enrolled individuals will receive full medical relief benefits until: (1) the department approves the individual's application for the program; (2) six months from the date that the individual was disenrolled from NJ FamilyCare; (3) the department determines that the individual does not qualify for medical relief benefits; or (4) the individual notifies the department that the individual wishes to opt out of the program. Participating medical relief service providers must agree to accept medical relief benefits as payment for qualified medical services and to charge the NJ FamilyCare rate for qualified medical services provided under the program. The bill establishes the New Jersey Medical Relief Fund (the fund) in the Department of the Treasury as a nonlapsing revolving fund, which will be the repository for Legislative appropriations for the program, plus the amount of State funding, as determined by the commissioner, that the State otherwise would have expended to provide NJ FamilyCare benefits for program participants. This bill appropriates $650 million to the fund, as well as the unexpended State funds resulting from NJ FamilyCare enrollees shifting to the program. The bill's provisions will take effect on October 1, 2026, but the State Treasurer and the commissioner may take actions prior to this date to implement the bill's requirements.

AI Summary

Committee Categories

Shanique Speight (D)*,  Joe Danielsen (D), 

Introduced, Referred to Assembly Aging and Human Services Committee (on 11/17/2025)

Official Document