Vermont creates its own health insurance exchange
BRATTLEBORO -- Navigators all over the state are helping people to enroll in the Vermont Health Connect, the state's new health insurance exchange.
"Obamacare or Affordable Care Act is a law in our country," said Green Mountain Care Board member Dr. Karen Hein. "Our job at Green Mountain Care is to implement a law."
The Green Mountain Care Board is an independent body that was appointed by Governor Peter Shumlin to regulate the new system. It is made up of five members.
The standards and prices of the exchange require approval from the board, which regulates the insurers' rates on the new exchange, hospital budgets and major expenditures.
The board is also responsible for advancing the exchange throughout the years with the goal of introducing a universal, single-payer system by 2017 looming over its head. Reforming payment and health care delivery are two tasks the board is looking at.
Vermonters have been setting up accounts through the exchanges' website, VermontHealthConnect.gov. They can also opt to enroll by telephone or paper.
The various standard plans are laid out on four different levels: silver, gold, platinum and bronze. Then there are high deductible plans and catastrophic plans.
According to the website, the levels "vary in the amount of monthly premium versus out-of-pocket costs, so you can pick a plan within the level that best meets your particular medical needs and budget. All plans offer the same quality benefits, known as Essential Health Benefits, including preventive care, mental health services and dental and vision coverage for children."
Plans available through the new exchange are available through the insurance companies Blue Cross Blue Shield and MVP.
"Every time (the two insurance providers) want to change their rates, we have to approve," said Hein. "We are ratcheting down those rates."
It was recently announced that Vermonters will now have until March 31 to enroll after Shumlin expressed frustration over tests indicating failures within the exchange's website. Originally, a deadline for enrollment had been set for the end of the year. The extra time was given so that people won't lose their coverage if problems with the website aren't solved before then.
The town of Dover had experienced difficulties setting up employee accounts online. Although it had established an employer account through the website, Assistant Town Clerk Jeanette Eckert told the Selectboard she hasn't been able to have employees enroll, including herself.
On Nov. 4, Vermont Department of Health Access Policy and Planning Chief Cassandra Gekas said that details regarding enrollment were still being worked out.
"I think our goal at the exchange is to make sure Vermonters have access to high quality coverage," she added.
Gekas also differentiated between problems seen in the national health care arena and the Vermont exchange.
"The problems you're seeing, I think, is in all the states letting the feds do it. We have our own vendors," she said. "We're seeing Vermonters able to get through our system. We have control over ours ... We're sitting with the contractors making our website. It's a much different situation than what you're seeing with the federal government."
With the extended deadline, those with individual or small business health plans will now have the option to extend their current plan until that date while continuing to pay their 2013 premium rate.
Yearly deductibles will begin on Jan. 1 and will be credited to the new plan if the customer continues with the same insurance carrier.
Those on the state subsidized Vermont Health Access Program or Catamount Health, who do not qualify for Medicaid in 2014, will have their plans automatically extended to March 31. At any time before that date, they can enroll in any Vermont Health Connect plan.
There is also a subsidy calculator available through the exchange's website so that people can see what assistance is available before enrolling.
Chris Mays can be reached at 802-254-2311, ext. 273, or firstname.lastname@example.org. Follow Chris on Twitter @CMaysReformer.
TALK TO US
If you'd like to leave a comment (or a tip or a question) about this story with the editors, please email us. We also welcome letters to the editor for publication; you can do that by filling out our letters form and submitting it to the newsroom.