Governor Murphy Signs Fiscal Year 2023 Budget
On June 30, 2022, Governor Phil Murphy signed the largest state budget, $50.6 billion, in state history. The record increase in spending is due to an unprecedented surge in tax revenue this year that handed state leaders a surplus of nearly $9 billion, increasing spending by more than 9 percent from the previous year.1 The surplus is driving the largest property tax relief program in more than a decade, a second consecutive full payment of nearly $7 billion to New Jersey’s public worker pension fund, a state-level child tax credit and an historic surplus of more than $6 billion to prepare the state for tough times ahead.2
“The FY2023 Budget addresses a multitude of concerns directly, such as: responsible tax cuts and spending, surpluses, pension investments and debt avoidance.”
The FY2023 Budget agreement forged between the Governor and the Legislature maintains and builds upon the priorities the Governor unveiled during his budget address in March, continuing to get New Jersey’s fiscal house in order while redirecting more than 74 percent of the total budget back out in the form of grants-in-aid for property tax relief, social services and higher education, as well as state aid to schools, community colleges, municipalities and counties.3
Senate President Scutari (D-22) proudly announced the budget saying, “The FY2023 Budget was signed into law! I firmly believe this budget to be the single greatest budget in NJ history. The FY2023 Budget addresses a multitude of concerns directly, such as: responsible tax cuts and spending, surpluses, pension investments and debt avoidance.”4
At the heart of the record spending plan is a property tax relief program known as ANCHOR, a rework of the Homestead Rebate that includes $2 billion in property tax rebates for approximately 1.15 million homeowners and 900,000 renters in New Jersey.3 New Jersey homeowners pay the highest property taxes in the nation; the average bill statewide hit $9,284 in 2021, an increase of $172 over the previous year. Renters, who are currently facing historic rent increases, pay property taxes when landlords pass along those costs.5
Mental Health Funding
Lawmakers attempting to address the need for mental health services statewide directed money to children’s programs, schools, the opioid epidemic, suicide prevention, a new crisis hotline and an expanded program for mental health professionals.
The budget distributes a total of $480.5 million as grants-in-aid money to the Division of Mental Health and Addiction Services within the Department of Human Services. Grants-in-aid refers to money given out by the state to fund a program or project that does not need to be paid back. Of this amount, $5.62 million will be disbursed to a fund dedicated to adding more mental health professionals statewide, of which $4 million will be used to fund 10 new medical residencies, $800,000 to add four new psychiatry fellowships to address the needs of children and adolescents and $100,000 for outreach to promote new residency positions in the state, especially among medical students who are underrepresented in the field.6
Under an initiative by the federal government, the budget will provide $29 million for the rollout of the “988” mental health crisis and suicide prevention hotline, which went live on July 16, 2022. Two years ago, the federal government released a report recommending a universal three-digit number for the National Suicide Prevention Lifeline to simplify the process of seeking substance abuse and mental health assistance in a crisis. The goal of 988 is to expand access to critical mental health services and ensure we are connecting individuals in distress with the most adequate assistance.7
The budget also funds a sizable anti-hunger package, spearheaded by Speaker Coughlin (D-19), which will increase funding for Emergency Feeding Organizations by $65 million and provide $18 million to create a minimum payment in New Jersey’s Supplemental Nutrition Assistance Program (SNAP) that will help nearly 50,000 households.3 SNAP provides food assistance to families with low incomes to help them buy groceries through a benefits card accepted in most food retail stores and some farmers’ markets.
The budget also includes $15 million in state funding to raise Medicaid rates for maternity care providers, as well as funds for midwifery education and Central Intake Hubs to support families with young children.
The funding is part of $2.3 billion in federal pandemic funding Governor Murphy and fellow Democratic legislative leaders agreed to in the final days of budget negotiation, with little public oversight, to pay for infrastructure efforts, public benefit programs and pet projects. In the draft of the State Budget that Murphy presented in March, he asked the Legislature to approve $2.9 million for that work—funding left over from the previous year—which is also available for the project.8
The FY2023 Budget provides more than $794 million in funding for hospitals. New Jersey continues to support graduate medical education funding, providing $218 million to all teaching hospitals and $24 million in additional funding to the 14 hospitals that serve the greatest proportion of individuals enrolled in New Jersey Medicaid.
The budget includes $342 million in charity care funding, which is distributed to all 71 hospitals in the state and is used to support hospitals’ delivery of free or reduced-cost hospital care for low-income, uninsured and underinsured patients. The distribution of charity care is primarily based on the uncompensated care provided by each hospital.9
The State also continues its commitment to improving maternal outcomes and connections to behavioral healthcare by dedicating $210 million to the Quality Improvement Program in FY2023. All acute care hospitals are eligible to participate in this program.
The budget also includes $50 million toward a new University Hospital in Newark, the only public hospital in New Jersey. The 519-bed hospital not only serves the largest share of uninsured, underinsured and Medicaid patients, it is a Rutgers University teaching hospital and a level one trauma center tending to the most seriously injured people in North Jersey. It was created to help the ailing city rebound from the riots of 1967.10
The budget passed along party lines, with nearly every Republican voting “No”: 48-30 in the Assembly and 25-15 in the Senate.11 Senator Vince Polistina (R-Atlantic) was the only Republican in the upper chamber to vote in favor of the budget. Senator Polistina’s district mates, Assembly members Don Guardian and Claire Swift, both Atlantic County Republicans, crossed party lines in the lower chamber.
“This budget misses an historic opportunity to give back billions to taxpayers who are struggling with high taxes and inflation,” said Oroho (R-24). “Instead of the $8 billion of tax relief that Republicans proposed, Democrats are giving back scraps while doling out billions of dollars for pork projects that we can do without.”12
Republicans, who had attempted to forward their own tax relief package without success, railed against the proposals, warning the record level of spending would leave the state poorly prepared for an economic downturn, adding that the relief the budget contains would take too long to reach taxpayers or is too limited to be meaningful.
“The supposed tax breaks in this budget are a joke,” said Senator Declan O’Scanlon (R-13), the Senate’s Republican budget officer. “They’re designed to sound like you’re providing relief but really slap taxpayers in the face. Maybe you’ll save 24 bucks if you’re one of the very lucky 25 percent of people renewing their driver’s licenses. Maybe you’ll save around 20 bucks if you shop for pencils and paper for school.” 13
Governor Murphy Unveils “Strengthening Youth Mental Health” Initiative at National Governors Association
“While 90 percent of youth rate their mental health a priority, only 40 percent rate their mental health quality as high; nearly 50 percent report that they do not know where or how to access care or help, and nearly 50 percent report cost as a key barrier to accessing care.”
This past July, Governor Phil Murphy announced his new Strengthening Youth Mental Health initiative.14 The National Governors Association (NGA) Summer Meeting marked the beginning of Governor Murphy’s term as NGA Chair, succeeding Arkansas Governor Asa Hutchinson. Murphy has previously collaborated with Hutchinson on several issues, including supporting infrastructure investment, promoting STEM education and working to prevent mass shootings.
The unveiling of the Strengthening Youth Mental Health initiative comes amid an escalating youth mental health crisis, exacerbated by the COVID-19 pandemic. In a Centers for Disease Control and Prevention study, 37 percent of high school students reported poor mental health during the pandemic, and 44 percent reported persistent feelings of sadness or hopelessness.15 Additionally, a study conducted by the Born This Way Foundation found that while 90 percent of youth rate their mental health a priority, only 40 percent rate their mental health quality as high; nearly 50 percent report that they do not know where or how to access care or help, and nearly 50 percent report cost as a key barrier to accessing care.16
Governor Murphy outlined four complementary pillars the Chair’s initiative will advance:
- Prevention and Resilience Building: Create welcoming, supportive and healthy environments that seamlessly weave age-appropriate mental and behavioral health tools into the fabric of children’s lives in their schools, homes and communities
- Increasing Awareness and Reducing Stigma: Promote awareness of mental health resources and foundational mental health knowledge by expanding easy access points to education, helplines and state services to help ensure young people know how to seek the help they need
- Access and Affordability of Quality Treatment and Care: Build a robust system of supports—including by leveraging unique funding opportunities to supplement and amplify state investments
- Caregiver and Educator Training and Support: Expand existing training and supports to ensure those caring for and interacting with youth on a daily basis have the tools and understanding to identify mental health needs, and when and how to refer young people to care
Murphy said he chose this issue because, “[a]s challenging as the previous two years have been for us adults, we know the strain is nothing compared to what too many of America’s children were under. That,” he said, “includes remote learning and students missing out on socialization among their classmates, as well as graduations, proms and more. As governors, one of our most important and sacred responsibilities is to our state’s children.”17
Governor Lamont Announces Connecticut Expands Maternal Health Coverage
Governor Ned Lamont announced that the federal Centers for Medicare & Medicaid Services (CMS) has approved the state’s request to extend Medicaid (HUSKY) and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy. This extension will affect approximately 4,000 Connecticut residents who would have otherwise lost coverage after 60 days.18
While the majority of roughly 14,000 HUSKY clients who give birth, each year remain eligible for coverage after childbirth, some have become ineligible after two months.19 The extension of this coverage will allow all individuals 12 months of coverage to address postpartum health needs, which may include recovery from childbirth, pregnancy complications, mental health needs and chronic health issues. With high rates of maternal morbidity and mortality, the approval of Connecticut’s requested extension of coverage was hailed by state leaders as a big step in addressing maternal health.
“In Connecticut, there are on average five to six pregnancy-related deaths per year and about half of those deaths occur in the first six weeks to one year after pregnancy,” said Department of Social Services commissioner Deidre Gifford. “So, it’s very important that women have access to long-term care and not just to prenatal care or the immediate postpartum period but for that entire year after pregnancy.” 18
Additional changes are also scheduled for next year, including medical coverage for undocumented immigrant children up to the age of 8 will go into effect January 1, 2023, and postpartum care for undocumented immigrant women will follow in April of 2023.
Governor Carney Signs Multiple Pieces of Legislation Related to Maternal and Infant Health
Governor Carney signed multiple pieces of legislation this year related to maternal and infant health aimed at decreasing infant and maternal mortality and expanding services to communities across the state. The series of legislation will improve health outcomes for families and infants throughout Delaware.20
The Governor signed the following bills:
- House Bill 340.21 This bill revamps the Child Death Review Commission to include more focus on maternal concerns. The commission will be renamed the Maternal and Child Death Review Commission to reflect its existing dual focus. The definition of “maternal death” will also be updated and the Commission will reflect diverse membership that will include a midwife and one maternal and one child advocate from statewide non-profit organizations. In an effort to be transparent, the group will be required to publicly post its draft report and accept written public comment.
- House Bill 344 (s).22 This bill will require the Delaware Perinatal Quality Collaborative to provide bias and competency training for healthcare employees.
- House Bill 342.23 This bill will expand on current restrictions for using restraints on women in labor and will include women who are 13 weeks postpartum.
- House Bill 345.24 This bill ensures pregnant women or women who have given birth within the past six weeks who are subject to the custody of the Department of Corrections at Level IV or V have access to midwifery and doula services by requiring the department to make reasonable accommodations for provision of available midwifery or doula services.
- House Bill 343.25 This bill requires the Division of Medicaid and Medical Assistance to present a plan to the General Assembly by November 1, 2022, for coverage of doula services by Medicaid providers. The services will be provided by a trained doula designed to provide physical, emotional and educational support to pregnant and birthing persons before, during and after childbirth. This will include support and assistance during labor and childbirth, prenatal and postpartum support and education, breastfeeding assistance and parenting education.
- House Bill 234.26 This bill requires the Department of Health and Social Services, Division of Medicaid and Medical Assistance to take the necessary steps to expand Medicaid coverage to pregnant women from the current coverage of 60-days from the end of pregnancy under federal Medicaid regulations to 12 months from the end of pregnancy. As a consequence of the COVID-19 pandemic, pregnant women receiving Medicaid benefits cannot be dropped so comprehensive medical care and other health care services have continued beyond 60 days until 12 months after the end of pregnancy by virtue of the federal Determination that a Public Health Emergency Exists. This Act would continue that coverage after the Determination is not renewed. In the event that coverage under the Determination ends before the State Plan Amendment is approved, the State will be obligated to provide the cost of coverage for services provided to pregnant women during the period from 60 days until 12 months after pregnancy ends.