Vermont Steps Closer to Health Benefits Despite Heated Debates

Since President of the United States Barack Obama signed the Affordable Care Act (ACA) on March 23, 2010 — enacting comprehensive health insurance reforms in the United States ­— Vermont state officials have been working hard to adjust Green Mountain Care Medicaid to meet the requirements of a state-provided health care plan under a single-payer system. The state recently received $104 million in federal grant money to institute Governor Peter Shumlin’s consumer-based healthcare exchange — the precursor to the universal healthcare system expected to be instituted by 2017 — over the course of the next year.

The grant comes at a time when the healthcare debate continues to play out at the state and national levels, and the uncertain future of Shumlin’s healthcare plan, Green Mountain Care, reflects the uncertain future of healthcare provisions in Vermont and in the United States.

Vermont’s single-payer healthcare system was the first of its kind in the United States when it was ushered in by Shumlin in May of 2011, but the debate about the relative merits of government-run healthcare continues, as detractors — including Republican gubernatorial candidate Randy Brock — continue to express concerns that patients are adversely affected by the lack of choice they have under a single-payer system.

The constituent plans that fall under the umbrella of Green Mountain Care — the predecessor of Obama’s controversial “Obamacare” system of universal healthcare coverage — have been refined since May 2011 when Shumlin’s universal healthcare system was passed. Shumlin has laid out key steps for the implementation of the Health Benefit Exchange that will gradually expand to a universal Green Mountain Care coverage in roughly 2017.

Currently, Green Mountain Care programs provide low-cost or free coverage for low-income children, parents, the elderly and other individuals and also provide options for households. It covers health care services such as doctor visits, hospital care and prescription medicines. Green Mountain Care provides all Vermont residents with healthcare options. Shumlin reports “Vermont has the fifth lowest rate of uninsured residents in the country. The rate has been stable over the last five years.”

In May 2011, Shumlin passed Vermont Act 48, outlining a path to single-payer healthcare for all Vermonters. In accordance with his plan, Shumlin made small business tax credits available to encourage universal coverage. Shumlin has also created a timeline that anticipates the creation of the exchange enrollment system — which will allow small businesses and individuals who are not covered by their employer to research and select qualified healthcare plans online — by October 2013 and universal coverage beginning in January 2014.

Although certain Vermont groups welcome healthcare reforms, others sharply criticize them. Vermonters for Health Care Freedom, a non-profit organization based in Montpelier, Vt. opposes the change. The group is engaged in an awareness campaign that seeks to educate the public about the policy. Vermonters for Health Care Freedom cite the tax increase as unnecessary and the primary problem with the Green Mountain Care system, and the organization has expressed concern that the reformed healthcare system may not provide healthcare to Vermonters as efficiently and as effectively as the current system.

Brock states on his website that he envisions “a Vermont where prudent regulation, free choice and abundant competition have made the high quality and low cost of Vermont health care the envy of the nation.”

Brock proposes the adaptation of consumer-driven health care that changes to accommodate preferences of individual Vermonters instead of a compulsory health care wholesale mandated by the state.

However, more than 47,000 Vermonters remain uninsured, and Shumlin is currently working to guarantee that Green Mountain Care provides health insurance for all Vermonters.

The Vermont state government is currently requesting further federal funding for a “waiver for state innovation” for Green Mountain Care system that establishes a global healthcare budget for the entire state and a unified system of payment rules for compensating providers. These standards comply with the ACA standards and await approval.

Vermont hopes to use the $104 million in federal grant money to finalize the creation of the exchange outlined by Shumlin in Act 48. The funds will primarily be used to improve Vermont’s outdated information technology network — existing hardware is over 35 years old in many parts of the state — and to create public education programs to educate individuals and small business about the state’s online healthcare exchange, which will be called Vermont Health Connect when it goes online in October 2013.