Health care reform begins now

Vermont political leaders have a challenge this session: How to move to Obamacare without hurting low- and moderate-income Vermonters who are currently covered through the Vermont Health Access Plan (VHAP) and Catamount Health, two state-supported health care programs.

The state plans will be discontinued in 2014, when Obamacare kicks in and requires everyone to have health insurance. Obamacare could reduce health insurance premiums for many Vermonters, including those enrolled in VHAP or Catamount. However, Obamacare care will expose VHAP and Catamount participants to higher out-of-pockets costs—three times higher in some cases—if they get hurt or sick and need medical services.

The current estimate is that it would cost $18 million to $20 million in fiscal 2014 to provide people with the same level of coverage they have now through the state plans. Gov. Peter Shumlin’s initial response to the estimate was: “Obviously, we don’t have that kind of money around.”

When the governor speaks of “we,” it’s usually a reference to the people of the state. But in this case, “we” appears to mean state government that is somehow separate from the people of the state. The message seems to be: We, state government, don’t want to spend additional money for health care, so you, VHAP and Catamount participants, are going to have to cover the extra costs yourselves.

It’s not like these health care costs disappear.  It’s just that the governor wants someone other than state government—and broad-based taxes—to pay for them.

This wouldn’t be the first time a governor proposed shifting costs onto Vermonters in the name of saving the state treasury some money. But this particular move seems at odds with Vermont’s overall goals for health care reform: slowing the rising cost and developing a fair way to pay for the health care system so it’s available to all Vermonters.

When the Legislature addresses the transition to Obamacare for VHAP and Catamount participants for fiscal 2014, it should look to advance, not thwart, the goals of health care reform. In fact, this discussion is actually an important part of health care reform.

A better response to this funding gap would be: “Obviously, the Vermonters in VHAP and Catamount don’t have that kind of money around. We need to make health care more affordable, not less affordable, to our most vulnerable citizens.”