Health Website Frustrates Vt. Businesses
Lak Vorachak, left, of Lebanon, N.H., laughs while talking with coworker Corliss McLean of Braintree, Vt., at F.H. Clothing Co. in Quechee, Vt., on February 15, 2014. Vorachak, who has worked at F.H. Clothing Co. for 14 years, is on her spouse's insurance plan, and McLean, who just started a part-time job there, has health insurance through the state of Vermont. (Valley News - Will Parson) Purchase photo reprints »
Lak Vorachak of Lebanon, N.H., works at a sewing machine at F.H. Clothing Co. in Quechee, Vt., on February 15, 2014. (Valley News - Will Parson) Purchase photo reprints »
Bradford, Vt. — Last summer, Vermont Gov. Peter Shumlin stopped by Paul Perry’s business in Bradford to talk about health insurance.
The state was still months from launching its online insurance marketplace, VermontHealthConnect.gov, and Perry wondered whether this new provision under the Affordable Care Act was going to work. Shumlin assured him he had nothing to worry about, Perry said.
“I was sounding doubtful and he was saying, ‘You’ve got to get on board with this. It’s going to work. You have to trust me it’s going to work,’ ” Perry said.
Perry wanted it to work, too. He wanted an easier, cheaper way of offering his employees coverage. And because Vermont mandated that small businesses buy insurance through the marketplace, he had no choice. But, as everyone now knows, it didn’t work. The technical problems experienced with the website since the Oct. 1 rollout have been widely reported, and with each new “fix,” Perry has grown more frustrated.
He is not alone. Small-business owners throughout Vermont have experienced a kind of whiplash, saying they are exhausted after months of confusion and mixed messages that have repeatedly steered them in changing directions. Individuals can now enroll through the website, though small businesses cannot, and some wonder when, if ever, they will be able to.
“I think there’s definitely a lot of anxiety out there,” said P.J. Skehan, executive director of the Hartford Area Chamber of Commerce. “There have been a lot of changes. It seems still to be in a state of flux. I wouldn’t say they’re sure how it’s all going to fall out.”
Last summer, small businesses were told the website was ready to go. Then, after it’s October launch, many had problems setting up online accounts and none could pay their premiums through the website. At the end of the month, Shumlin told small businesses they could extend their current plans through March 31, at which point the website would, with hope, be ready. By January, the website worked for individuals who wanted to enroll, but it still wasn’t ready to handle employers. Now, all small businesses have to enroll directly with insurance carriers.
They spent time and money educating employees about their options, only to find out that those options no longer existed.
“There have been a lot of man hours spent preparing,” said Joan Goldstein, executive director of the Green Mountain Economic Development Corp. “There are also employee relations issues.”
Even direct enrollment has proved frustrating, not because there were technical glitches, but rather because it limited choice. Originally, employees of small businesses would have had 18 plans from which to choose offered by two insurance carriers, Blue Cross Blue Shield of Vermont and MVP Healthcare. Each offered nine plans a piece. Now, there are fewer.
Although MVP is still offering the full array, the largest of the two insurers, Blue Cross, trimmed its options to three for companies with more than 25 employees and just two for smaller outfits.
A Blue Cross spokesman said that is all it could handle on such short notice from the state, which began working on this contingency in November. Originally, the state would have administered the program. Now, that responsibility was on insurers.
“It was not possible for us to implement a full-employee choice model on short notice and also assure that members would be enrolled in their new coverage and have ID cards in their hands so they could access care on January 1st,” Blue Cross spokesman Cory Gustafson said in an email to the Valley News.
The concerns from small businesses have not been lost on lawmakers, who have been hearing complaints from their worried constituents since the day the website launched.
“Many are finding it frustrating that the choices are limited,” said Rep. Sarah Copeland Hanzas, D-Bradford, who is vice chairwoman of the House Committee on Health Care.
Employers have workers who span a range of incomes, she said, and fewer options mean there will be fewer opportunities to find coverage affordable to everyone.
“It was definitely something I was concerned about,” Perry said.
Ultimately, he opted for a high-deductible plan akin to the “bronze” level. In the online marketplaces, plans are categorized by “medal” levels, with bronze having the lowest premium costs to employees, but the highest deductibles. The next level, silver, has higher premiums but lower deductibles, and so on with gold and platinum.
Some of Perry’s employees wanted a higher level of coverage, but the premium costs would have been too expensive for lower-wage employees.
“I felt I had to go with that plan to protect those employees,” he said, “which meant that some of the other employees that had upgraded to better plans, platinum plan in a couple cases, they’re going to have to be satisfied with the lower premium plan.”
For others, limited plan choice has been a concern, but not a major issue. Montpelier consulting firm Stone Environmental had only a few people who picked a plan originally that was not aligned with one of the three options offered directly through Blue Cross, said Steve Karcher, the firm’s chief financial officer.
So far, Stone employees have been accepting of the limited choice, mostly because their share of the expenses for health insurance hasn’t changed, he said. But that is not to say they are generally happy with how things have gone.
“I think we had a fair amount of confusion and frustration around the process, the kind of stop, start,” he said. “But in the end, I don’t know that we’ll know, until our employees are being covered by this, just how happy they’ll be.”
As of last Tuesday, nearly 2,000 small businesses representing more than 18,000 employees had enrolled directly with Blue Cross and several hundred more businesses accounting for 20,000 workers are expected to do so over the coming months, Gustafson said. MVP did not have figures available last week.
For now, employers say they are happy to have their workers covered, though Perry still is anxious.
“I don’t know what’s happening at the end of the year,” Perry said. “We have more anxiety because we don’t know if we’re going to go through this whole thing again.”
State officials haven’t given a specific date when they expect it to be ready, but say it will be rolled out as soon as possible.
“We continue to develop and test the small-business portion of Vermont Health Connect,” said Mark Larson, commissioner of the Department of Health Access, in an email to the Valley News on Friday. “We will launch it as soon as we’re completely confident that it can effectively serve small-business owners and their employees.”
Joan Ecker is confident that the situation will get better. But then, she is among the small-business owners who doesn’t have to deal with the website. She stopped offering insurance after the marketplace rolled out.
Ecker, who owns F.H. Clothing Co. in Quechee with her daughters Jenn and Sara, believes that “health care is a right and not a privilege.” She has been a vocal supporter of the Affordable Care Act and said Shumlin’s push to establish a state-run system by 2017 is “my goal and dream.”
Ecker used to offer insurance to her full-time workers, covering 50 percent of the costs. But when she ran the financial numbers, it didn’t make sense to have a policy. She has a small staff of a dozen full- and part-time employees, and most had coverage through other means, such as a spouse. In the end, two people ended up buying insurance through the exchange as individuals, said Sara Ecker. “Both of our people who bought insurance, it was an easy process,” she said.
If there’s a frustration, it’s that the individual plans are not affordable to everyone, she said. At least two F.H. Clothing employees have decided not to buy insurance for that reason — they either didn’t qualify for a subsidy or the subsidy was too small to make much of a difference — and take the tax penalty, which is $95 per person this year.
Ecker still supports government-run health care and what Vermont is trying to accomplish with its marketplace. But the experience of the past few months has shaken the confidence of other small-business owners, said Goldstein, of Green Mountain Development Corp.
“There are obviously skeptics,” Goldstein said. “And there are people who are hoping for the best because the alternative is too upsetting. But yeah, skeptics abound.”
Chris Fleisher can be reached at 603-727-3229 or firstname.lastname@example.org.