Roque, Prieto, Romano explain their issues with Horizon’s OMNIA plan

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West New York Mayor Felix Roque, Assembly Speaker Vincent Prieto (D-32) and Hoboken Freeholder Anthony Romano (D-5) spoke to Hudson County View one-on-one to explain their individual issues with Horizon’s proposed OMNIA plan. 

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Roque, who works as a pain management specialist just a few blocks from town hall, said the OMNIA plan only benefits Horizon Blue Cross Blue Shield.

“I’ll tell you, in medicine, every second counts. So if you have a heart attack, or something happens, and now you know you cannot go to the local facility, you have to go someplace else,” he told Hudson County View.

“And at the end of the day, big insurance companies do everything for their own benefit. This is not about saving taxpayers money or to save people from their deductible, it’s all about [the provider] saving money. At the end, who gets hurt? It’s the consumer.”

Prieto noted that given the large urban population in Hudson County, the proposed tiered healthcare plan is “very, very problematic.”

“When you have very urban areas, that are very densely populated – and these individuals are less mobile, they can’t get to other places – then it [would] be very difficult for them to go to a Hackensack hospital,” he said.

” … Other safety net hospitals, that provide a service, in this area as acute care facilities, could fail and close – and that we cannot have.”

Romano, who was involved in the fight to keep the doors of the Hoboken University Medical Center open back in 2011, believes that the OMNIA plan would mean the battle was all for naught.

“Through a collaboration of the different levels of government, we were able to save the hospital. Now, at the same time, CarePoint came in and improved the physical plant, as well as the morale, the number of employees that work in Hoboken and Jersey City, that are in the hospital.”

“Plus, the hospital is the center hospital for Hoboken, Union City, Weehawken and parts of Jersey City. So now, after reaching this point, for Horizon to do this, especially since a lot of the people who use our hospital use public transportation.”

“And others, government employees that are affected after working for many years, now see these changes being done without a notification, or an ability to voice their concerns and questions, it’s just not right.”

Following yesterday’s press conference in front of Jersey City’s Christ Hospital, Horizon said they are “not taking anything away from consumers” and look forward to answering questions and clearing up misconceptions about the program at the October 5 Senate hearing on the topic.

3 COMMENTS

  1. isnt Mayor Roque accused of insurance fraud on the sum of 500k ???? If less dr like Roque were not committing insurance fraud, then the insurance companies would not be force to do what they are doing!

  2. Why don’t those hospitals self underwrite and have a staff model like Kaiser Permanente? No arguments about medical necessity make sense here – it is a failure of the hospitals to negotiate. That is evidenced by other national insurers pulling out of these hospitals.

    Having politicians interfere with insurance companies makes no sense. The NJ US Senator that twisted the arm of a health insurer to pay for the uncovered cost of a medical evacuation for a baby from Portugal, is a cost that gets spread to the rest of the policyholders.

    Roque, Prieto and Romano you are only squeezing a ballon. Did you talk to Horizon regarding their negotiation of hospital rates. Did you talk with Aetna and see if these reasons were similar? Perhaps the hospitals could be managed better if they want to deal with the insurance being underwritten by a carrier. I assure you if they self underwrite they will find their operations at a loss.

  3. This notification argument is bogus also, it is the hospital that that failed the employees covered in the plans. I was with Aetna and same thing, I found out I could not use these hospitals only after the hospitals failed to negotiate. The hospitals have to be able to maintain medical cost at a level of other surrounding hospitals. If the ordinary levels of claim exceed the level of other hospitals the hospital and associated facilities need to take a look at the management and operations.

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