Vt. Gears Up Health Market For Residents

State Estimates 270,000 Users Will Tap Exchange for Coverage

West Lebanon — Most of the heavy lifting to set up Vermont’s health insurance exchange is finished, and now state regulators will be spending the coming months helping businesses and individuals figure out how to use it.

Rates for health insurance that will be sold through the exchange, called Vermont Health Connect, were announced Monday and state health officials are now sorting through more than two-dozen plans that could be offered when the system launches Oct. 1, health officials said Tuesday in a meeting with the Valley News editorial board.

The biggest concern now is making sure that the estimated 270,000 Vermonters who will be using the exchange have the information they need.

“We’re well on our way to be ready for Oct. 1 and part of our attention has really switched to how do we help Vermonters be ready to use Vermont Health Connect,” said Mark Larson, commissioner of the Vermont Department of Health Access.

The exchange, a key provision of the Affordable Care Act, is like an online shopping mall for health coverage. Health officials have compared it to a website retailer, such as Amazon, for insurance plans. Vermont is one of 17 states that is running its own exchange rather than handing the reins to the federal government, according to the Kaiser Family Foundation.

Individuals and families who do not get health insurance through their employer, and businesses with fewer than 50 employees, will be able to buy private insurance coverage through Vermont Health Connect when open enrollment begins in October. Those who do not buy insurance face a tax penalty under the federal law, though there are a few exemptions.

Officials believe as many as 100,000 people will buy private insurance through the exchange in the year or so after it launches in October. Another 170,000 people on public insurance plans, like Medicaid, will also use the exchange to access coverage.

There remains a lot of work to be done, however, in educating consumers on how to use it, Larson said.

The state is relying on its website, VermontHealthConnect.gov, to inform consumers and answer their questions. Through the website, Vermonters can compare health insurance options, enroll in a plan and find out whether they qualify for financial assistance.

In September, Vermont will open a customer support center that people can call over the phone with questions. Vermont is also working with 18 organizations from around the state to train “navigators,” experts who will meet in-person with individuals and business owners to walk them through the enrollment process.

Finally, state officials are using social media to reach out to younger people who do not have insurance.

“We have a Facebook page, we have a Twitter account, we’re creating a YouTube channel where we’ll post videos so we can try and meet that younger uninsured population where they’re more likely to be,” said Robin Lunge, director of health reform in Vermont.

Health coverage begins in January 2014 and open enrollment runs from October through March 2014.

Under federal law, all state health insurance exchanges have to offer a standard level of benefits, but with different costs depending on the level of coverage.

The different levels are identified by “metals,” such as “bronze,” “silver,” “gold” and “platinum.” The difference among levels is in how the costs are split between the insurers and consumers.

In bronze plans, the premiums are lower but the co-pays, deductibles and other costs are higher. At the other end of the spectrum, platinum plans have higher premiums but lower co-pays and deductibles.

The rates approved Monday were roughly 4 to 5 percent lower than what the state’s two insurers — Blue Cross Blue Shield of Vermont and MVP Health Care — had originally proposed.

A single person enrolling in a “silver” plan would pay a monthly premium of about $395 for Blue Cross coverage and $410 per month for the equivalent through MVP.

The Blue Cross family plan will cost $1,111 a month and MVP will be $1,151.

Lower income Vermonters currently on Vermont Health Access Plan, known as VHAP, or Catamount Health will either move to Medicaid or have to buy insurance through the exchange starting in January 2014. But there will be financial assistance available to help them cover increased costs, Lunge said. Even a family of four earning $94,000 a year will be eligible for financial help.

The subsidies will come via federal tax credits and also some state money set aside in the budget approved earlier this year. Vermont is paying for the exchange with existing revenue, some of which will come from the money saved when VHAP and Catamount are eliminated in January.

Past experience in offering state health programs have helped prepare Vermont for the rollout of the exchange, according to officials.

When Catamount was introduced, the education initiatives paled in comparison to what is being done now, said Peter Sterling, executive director of the Vermont Campaign for Health Care Security Education Fund, a nonprofit that helps consumers access publicly funded insurance programs.

Sterling has been impressed with Vermont’s efforts to educate consumers before the exchange goes live.

Education efforts with Catamount didn’t begin until after the program began, he said. Sterling was encouraged that the state was working with community organizations now on outreach several months before people have to enroll.

“Consumers are going to have a choice of 20 to 25 different plans and getting everyone educated to make sure they make the right choices for them is going to be a challenge,” Sterling said. “This has been a 180-degree difference from Catamount.”

Larson said Vermont has learned from the past.

“If we think about what our goals are and we think of Vermont’s long history of doing health reform ... we’re starting from a place that a lot of states aren’t, and so it feels dramatically less dramatic here than other places,” Larson added.

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.