Other states should protect Medicaid
New Jersey leaders are committed to health plan
By: Debra L. Wentz
Your Turn
Guest columnist
..... Sometimes, it can be hard to find good news in the world today, but there is some her in New Jersey.
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Preliminary data for the 12-month period ending April 2025 shows a 30% decrease in fatal overdoses compared to the preceding 12-month period. Tragically, we still lost 1,799 lives to overdose between April 2024 and April 2025 - but for the first time in nearly a decade, the number was fewer than 2,000.
..... This promising reduction is no accident. It reflects years of sustained commitment by New Jersey's leaders to expand access to treatment for substance use, strengthen recovery supports and incorporate the perspectives of those with lived experience in crafting health policy.
..... From robust investments in harm reduction and evidence-based medications to treat substance sue to ongoing efforts to better integrate behavioral health into primary care, New Jersey is building one of the strongest substance sue treatment systems in the country.
..... The state is also taking proactive steps to safeguard Medicaid - the single largest payer of substance use care
in the nation, - ensuring that New Jersey beneficiaries who rely on this health plan can continue to access lifesaving care. Today, [12/05/2025] 1.7 million children and adults are enrolled in New Jersey Medicaid, and according to a 2022 report from the state department of Human Services, 70% of all New Jersey residents who received substance use treatment in 2021 obtained their care through Medicaid.
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The state's efforts to protect this essential health plan come at a critical time, as new federal policies threaten to strip coverage from millions across the country. H.R. 1, the federal spending bill enacted this summer, [2025] slashes federal Medicaid funding and imposes work requirements for Medicaid expansion enrollees. these changes are predicted to result in massive coverage losses - jeopardizing treatment access for hundreds of thousands of our loved ones, neighbors and fellow New Jersey residents.
..... But once again, the Garden State is showing the nation what leadership looks like.
..... already, state policymakers, administrators and advocates are moving swiftly to mitigate the impact of H.R. 1 and protect those most at risk. Mirroring many of the strategies recommended in a recent report from the Legal Action Center, New Jersey leaders are working to not only maximize exemptions from H.R. 1's new work requirement, but to also reduce the burdens associated with reporting for both enrollees and state Medicaid employees.
..... New Jersey's Division of Medical Assistance and Health Services, or DMAHS, has set its north star goals, which include maintaining enrollment of existing enrollees covered and minimizing the added burden on members. DMAHS has established key steps to systematically identify both exempt and compliant enrollees (those who have already met SNAP work requirements or whose income or other data show compliance). DMAHS plans to use Medicaid eligibility data to identify caregivers with dependent children under 14 and Medicaid claims data to identify medically frail individuals, which will include encounter data for inpatient substance use treatment.
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Ongoing efforts are also underway to identify other data behavioral to the state that can identify additional exempt groups such as pregnant and post postpartum women, foster youth and former foster youth and veterans with rated disabilities.
..... At the same time, the data strategy DMAHS is developing will consider temporary hardship exemptions that are available, including for individuals living in counties with a high unemployment rate, among others.
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Further, data from he Department of Labor and national payroll databases will be sued to verify incomes more than $580 a month (80 times the federal minimum wage) while DMAHS continues to identify other data sources that prove compliance. Among those being explored are the Centers for Medicare and Medicaid Services' tool hat individuals can use to automatically upload their work hours and any educational enrollment data that might be available. DMAHA is laudably exploring every avenue to take the burden off of enrollees and ensure all who are eligible maintain their coverage.
Crucial work for people with substance use disorders
..... For prole living with substance use disorders, this work is critical as this population already faces steep barriers to care - not to mention employment p stemming form widespread stigma and discrimination. Moreover, any gaps in Medicaid coverage during there treatment or recovery threatens not only their engagement and helaht status, but it can also jeopardize their housing, job prospects and overall stability, unsurprisingly raising the risk of overdose.
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States nationwide should take note: If they want overdose rats to keep falling, follow in the Garden State;s footsteps when implementing H.R. 1. Like our state, they can work to ensure medicaid enrollees impacted by substance use - as well as other vulnerable populations - maintain their coverage and access to lifesaving care.
..... Debra L Wentz, PhD, is president and CEO of the New Jersey Association of mental Helaht and Addiction Agencies.