Vt. Health Exchange Gets Federal OK

Insurance Program Approved, Will Be Ready by October 2013

Montpelier — Vermont has won conditional federal approval for its plan to build a consumer-friendly health insurance marketplace, officials announced yesterday.

“We commend Vermont for taking this important step towards providing affordable health insurance for consumers,” Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, wrote to Gov. Peter Shumlin yesterday.

Vermont is now one of 19 states, plus the District of Columbia, to have gotten word from a division of Sebelius’ agency that they are on track to have a health exchange ready for business by Oct. 1.

Vermont’s version will be called Vermont Health Connect. It will allow individuals, families and small businesses to review coverage and costs using a Web-based tool and will provide personnel to help less Web-savvy consumers through the process.

Robin Lunge, Gov. Peter Shumlin’s director of health reform, said state officials saw cause for celebration with the federal OK, but he added that much work remains to get the exchange up and running by October, when it’s scheduled to begin enrolling consumers.

Insurance companies are to submit bids shortly for what kinds of products they want to offer through the exchange and at what prices, she said.

The state also will be requesting proposals for organizations that want to provide navigators — people who will guide consumers through the process of shopping for insurance in the exchange, Lunge added. She said organizations providing navigators could include hospitals and community action agencies.

Vermont is unique among the states in that, under legislation passed in 2011, it is looking to use the exchange as a springboard toward a state-run, single-payer health insurance system by 2017 that will be similar to the current federal Medicare program for older and disabled Americans but available to all Vermonters.

The conditional approval yesterday drew praise for the Shumlin administration from the head of a group that has been sharply critical of Vermont’s longer-term single-payer plan.

“Most of the material that I’ve read indicates that Vermont is ahead of the pack relative to other states that are working to set up health care exchanges,” said Jeff Wennberg of Vermonters for Health Care Freedom. He praised the administration’s progress on “a nearly impossible task, given the time frame.”

Shumlin said in a statement: “Vermont continues to be a leader in health care reform, and this is another illustration of our progress toward meeting our reform goals. We are building an Exchange that works for Vermonters now and in the future.”

The statement described Vermont Health Connect as “the marketplace for individuals, families, and small businesses to compare and purchase qualified private health insurance plans, determine eligibility for and enroll in public health insurance plans, and access tax credits and financial assistance to make insurance affordable.”