New Jersey is competing harder than ever for jobs, investment and talent. As the Sherrill administration and the business community look for industries to anchor the state’s growth, one already does at enormous scale and in every county: health care.
Modern health systems are no longer simply providers of care; they are among the nation’s largest employers, workforce training platforms, research enterprises and technology adopters. As the Wall Street Journal observed, health care has become one of the country’s defining middle-class jobs engines — even as it grows as a center of innovation in data, AI and the life sciences.
Consider a single system. RWJBarnabas Health is New Jersey’s largest private employer, with more than 45,000 employees — over 11,000 of them nurses — across 14 hospitals, 9,000 affiliated physicians and more than 700 care locations. We treat roughly one-in-four New Jerseyans, have a $7 billion-plus annual economic impact and are the state’s largest safety-net provider.
Collectively, the New Jersey Hospital Association reports that the state’s acute-care hospitals employ roughly 162,000 people, paying about $12 billion a year in salaries. They buy $5.5 billion annually in goods and services from other New Jersey businesses and spur an estimated $78 billion in economic activity. And each hospital job supports another 1.5 jobs elsewhere, impacting an additional 236,000 jobs statewide.
And this is only the beginning. The U.S. Bureau of Labor Statistics projects health care and social assistance to be the country’s largest sources of new jobs and its fastest-growing industry sector through 2034 — with 8.4 percent growth over the decade and roughly 1.9 million openings a year. Driven by an aging population and rising chronic disease, these new positions offer a median wage two-thirds above the median salaries for other occupations.
We applaud Gov. Mikie Sherrill for putting innovation and the “opportunity economy” at the center of her agenda. Innovation in health care is not a side benefit of our state’s economy. Increasingly, it is the economy.
Yet this engine is not self-sustaining. It depends on a policy environment that lets providers invest, hire, and keep their doors open — an economic climate now under pressure from two directions at once.
The federal budget law enacted last summer cuts Washington’s Medicaid spending by hundreds of billions of dollars over the next decade. Combined with the expiration of enhanced Affordable Care Act subsidies, it puts coverage at risk for as many as 350,000 New Jerseyans and reduces payments to the state’s hospitals by an estimated $300 million. When people lose coverage, they do not stop getting sick — they arrive later and sicker, driving up uncompensated care and straining hospital resources.
We share the goal of more affordable care for families and employers and providers have an obligation to meet it through increased efficiency, transparency, care coordination and outcomes. But some remedies under discussion in Trenton would do more harm than good.
Proposals for rigid state mandates and price caps — in particular “reference-based pricing,” which pegs hospital payments to a fixed percentage of Medicare rates — risk reimbursing care below its actual cost. Medicare already pays many hospitals less than cost. If you lock that in as the benchmark, the results are predictable: reduced services, longer waits, pressure on safety-net hospitals and costs shifted onto the very consumers these policies aim to protect. Affordability achieved by squeezing access is not affordability at all.
This combined pressure threatens the investments that have made New Jersey’s health care among the best in the country — the academic medical centers, cancer institutes, and specialized programs that draw patients here rather than out of state. For example, RWJBarnabas Health’s partnership with Rutgers University provides New Jersey patients close-to-home access to breakthrough research and clinical trials from the Rutgers Cancer Institute — the state’s only NCI-designated Comprehensive Cancer Center — and the new Jack & Sheryl Morris Cancer Center, the state’s first and only stand-alone cancer hospital.
Such research partnerships, clinical trials, data and AI tools all depend on margins that are already thin. Squeeze reimbursement below cost, and these are the first to go. None of this means New Jersey should stand still on cost or transparency. It means being honest about what is at stake with reduced resources from “race to the bottom pricing.” You cannot underfund the system and expect it to keep innovating. These misguided policies threaten the technology and innovation ecosystem the Sherrill Administration has rightly made central to its agenda.
And it jeopardizes economic growth itself — and the workers who power it. Health care is not only among New Jersey’s largest employers; it is among the largest employers of unionized labor in the state, anchoring tens of thousands of jobs through HPAE, 1199SEIU, and others. Pressure on hospital resources is pressure on nurses, technicians, and front-line caregivers — and the nearly 400,000 jobs this sector sustains.
New Jersey has a better path, and a growth-focused administration willing to work with employers, providers and labor. Let’s protect what’s working: keeping people covered, paying fairly for care delivered and pursuing affordability through competition, innovation and provider-led improvement rather than arbitrary caps.
Get it right, and we will keep delivering world-class care, powering the innovation economy and creating good union jobs all across our state.
Get it wrong, and we slow the Garden State’s most dependable engine of growth. That is a mistake New Jersey cannot afford.
George Helmy is Chief Corporate Affairs Officer of RWJBarnabas Health and former U.S. Senator from New Jersey.
