A New Jersey lawmaker says Gov. Chris Christie has decided to extend Medicaid coverage to more low-income New Jersey adults in a decision to implement a major slice of President Barack Obama's health insurance overhaul.

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State Sen. Joe Vitale, a Democrat who is chairman of the Senate committee that deals with health care, said he had been briefed on the Republican governor's decision. Health advocacy groups also said they had been told of the decision on Tuesday.

The decision means that more low-income New Jersey residents -- 300,000 of the state's estimated 1.3 million uninsured residents, according to one study -- can be covered under the joint federal-state health insurance program. If lawmakers agree, the coverage becomes effective on Jan. 1, 2014.

Christie had not given many hints about how he would handle the major decision. His path was cleared a bit as seven other Republican governors have endorsed the expansion despite misgivings about the overall health care changes.

Including New Jersey, 22 states and the District of Columbia have signed on to the expansion and 14 states have rejected it. The rest are still considering what to do.

Under 2010 federal law, Medicaid expansion was initially mandatory. But the U.S. Supreme Court made it optional for states.

The federal government offers a major incentive: It has agreed to pay the full cost of the expansion for three years and 90 percent of the cost after that.

"It's a wise decision and it will provide affordable health care for tens of thousands of New Jerseyans," Vitale said Tuesday, adding that it would mean an influx of money to the state's hospitals. "It's long overdue."

Under current policy, only very low-income childless, non-senior, non-disabled adults -- those earning less than about $2,800 per year -- qualify for Medicaid in New Jersey. The federal law, often called Obamacare, is using health insurance exchanges to allow higher-income people to buy health plans. But without the expansion, there would be a group of people who would likely go uncovered. With the expansion, an adult without children earning up to $15,415 can be added to Medicaid.

In New Jersey, advocates for the poor were pushing the state to join, saying it would expand health care access and help the state's economy because of the influx of federal health care spending. A study by the liberal New Jersey Policy Perspective says that the expansion would save the state nearly $2.5 billion by 2012, mostly because of the federal government picking up Medicaid costs.

Many groups in the medical world, such as doctors and hospitals, like the concept, but have concerns about how it will work.

Some worry that with a shortage of doctors, there will be more patients with insurance but not significantly increased access to care.

And hospitals worry that their charity-care funding from the state will be slashed even though a significant uninsured population -- largely illegal immigrants -- will remain.


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