Vermont is working hard to get its health exchange – called Vermont Health Connect – up and running by this October, when businesses with 50 or fewer employees and individuals will begin using it to enroll in health insurance. Blue Cross/Blue Shield of Vermont and MVP Health Care have submitted their proposed rates for premiums to the State for review. One other provider, the member-owned Vermont Health Coop, is trying to get licensed as an insurer so it, too, can sell insurance on the exchange. The proposed premiums are in line with amounts being paid today.
In many ways the fact that the proposed rates did not skyrocket as predicted is not surprising. Over the last two decades, Vermont created Dr. Dynasaur for children, banned health insurance companies from imposing higher rates on the sick and elderly than they would on the young and healthy, expanded Medicaid, created and subsidized the Vermont Health Access Plan (VHAP) and Catamount for uninsured low income adults, and devised pharmacy programs to ease the cost of medications. All these changes had the effect of insuring more Vermonters and providing increased access to health care. In Vermont, unlike the rest of the country, over 94% of the population is insured. Our health insurance companies have already had to adapt to Vermont’s requirements, which made it easier for them to propose rates that are consistent with the national insurance reforms that are new to other insurers and states.
Nonetheless, there is concern for the people whose premiums will increase under the proposed rates. Principally, these people seem to be lower income single parents who were previously insured through Catamount. Catamount, like VHAP, will be going away January 1, 2014. These individuals will qualify for federal subsidies under “Obamacare,” which caps premiums at a certain percentage of household income. There will probably be state subsidies as well. Right now, the Vermont House approved state subsidies that lower the federal caps an additional 1.5%. Still, even with proposed premiums that are in line with what we pay today, plus federal and state subsidies, one vulnerable slice of our population, lower income single parents, may pay more. The Senate is struggling with how to help this group. As always, it is an issue of where to find the money.
While the funding is being analyzed and debated in Montpelier, it is important to remember the good that comes to all Vermonters from the exchange. Coverage will be standardized so people can shop for and understand what their insurance will cover. Insurance products will differ in the amount of out of pocket costs, but the essential benefits will be the same across the board.
Out-of-pocket costs, including premiums, will be capped. No matter what chronic or catastrophic health condition occurs, the likelihood of having to file bankruptcy because of overwhelming health care costs is vastly reduced.
Vermonters cannot discount the difficulty faced by those of its citizens who may face cost hikes, as modest as they may appear to many people. But this State’s progress in moving toward an understandable and affordable health care system is an achievement no other state can claim.
photo by Jonathanking
