On Friday, in a statement released to NJ Advance Media, Horizon officials confirmed offering the administration a substantial but unspecified amount of money. The money, Horizon officials said, would be used over two years to create a temporary fund for health care programs.
The company said it suggested the money should come from savings Horizon would recoup by the legislature passing a long-awaited law limiting surprise, out-of-network medical bills.
One of the three sources said Horizon brought up the legislation in the talks, but also offered the partnership without tying it to the bill. A Horizon spokesman said this assertion was false.
Regardless, Christie was angling for almost three times the $135 million, or the $300 million. After negotiations broke down, Christie put Horizon on the defensive in his budget address on Tuesday.
Christie took aim at Horizon’s not-for-profit status by pointing out the company is sitting on $2.9 billion in reserves. He suggested a portion of that money could be used for drug treatment programs to help curb the state’s heroin and opioid drug epidemic, which the governor has made a priority in his final year in office.
“I am confident Horizon will embrace this opportunity and partner with us to establish this permanent, sustainable fund,” Christie said in his budget address. “They will not turn their back on the people of New Jersey who pay their salaries.”
In a statement released after the speech, Horizon criticized Christie for suggesting the state “raid the reserves that protect” the 3.8 million members it insures.
For nearly eight years, state lawmakers have struggled to enact a law that would limit surprise out-of-network billing practices by a handful of doctors and hospitals. Horizon, one of the loudest proponents of the legislation, say the practice costs insurers $1 billion a year and drives up insurance premium costs.
Horizon “also sought to ensure funds would be used to benefit New Jersey’s Medicaid population,” McArdle said. “Our goal was to find a way to work with the Governor while lowering the cost of health care and health insurance for our members.”
Horizon is New Jersey’s largest Medicaid provider, serving 900,000 of the nearly 1.8 million people in the program, according to the company. Horizon is both a not-for-profit entity and a tax-paying health service corporation that until its restructuring in 1992, was known as the “insurer of last resort” for the poor.
The company reported $11.5 billion in revenue and paid about $515 million in federal and state taxes and insurance assessments in 2015, according to the company’s website. Horizon also held about $2.4 billion in reserves last year, according to its statement Tuesday.
“Horizon remains committed to improving the health and well-being of New Jersey and to partnerships that achieve those goals, but will oppose any effort to reduce member reserves and make health insurance more expensive and less secure,” McArdle said.