State drafts rates for upcoming health care exchange

MONTPELIER (AP) — Vermont became the first state in the country last week to let people without health insurance see how much they could have to pay to get coverage through the federal health overhaul beginning next year.
The state on April 1 released the proposed rates that would be charged for a variety of coverage levels through the state’s health insurance marketplace. The rates range from an average high of about $1,700 a month for a family to an average of $745 for catastrophic coverage — only available to people under age 30 — for a family.
The raw figures don’t take into account government subsidies that would lower the costs.
Examples provided by the state of Vermont show that a family of four with an annual income of $32,000 would end up paying $45 a month out of pocket. A single person with a $40,000 income would pay $317 a month. A small business that offers its seven employees catastrophic care with a $2,500 deductible would see its monthly cost reduced from $10,240 to $8,000.
The rates offered by Blue Cross Blue Shield and MVP Health will be reviewed by the Department of Financial Regulation before a final approval by the Green Mountain Care Board.
“Everyone on the team is very excited to have a tangible sign of progress,” said Robin Lunge, Vermont’s health care reform director. “People have been working very hard behind the scenes” to have the marketplace, known as an exchange, operating by Oct. 1 so people can choose coverage that would start Jan. 1.
Two Addison County legislators played a substantial role in development of the state’s new health care exchange.
Rep. Mike Fisher, D-Lincoln, is chairman of the House Health Care Committee.
“People have been asking me for two years, ‘What is (health insurance) going to cost?’” Fisher said. “Here is the first glimpse at an answer to that question.”
He is pleased that the proposed rates aren’t wildly divergent from those currently offered in the current marketplace.
“There was concern that there would be sticker shock, but that has just not taken place,” Fisher said.
He stressed that these are merely proposed rates. They still must be reviewed and endorsed through the state’s Department of Financial Regulation and the Green Mountain Care Board.
Sen. Claire Ayer, D-Addison, is chairwoman of the Senate Health and Welfare Committee.
“It’s good news,” Ayer said of the creation of the health care exchange. “I’m very pleased.”
Like Fisher, she’s happy that the exchange would not result in large rate increases for most participants. Ayer said many prospective participants should see decreases, with a notable exception being some small group insurance pools “that might not do as well.”
Ayer believes the exchange will be a boon for hospitals, in terms of being able to plan more predictable budgets. And the state is looking to increase Medicaid reimbursement rates for physicians, Ayer noted.
In one sense, the posting of the rates in Vermont is symbolic, but it’s a process that is due to be repeated in every state, in one form or another, by the end of the year, said Andy Hyman, a senior program officer at the Robert Wood Johnson Foundation, who follows health care changes.
“It’s a very exciting day,” Hyman said this past Monday, April 1.
“Every state over the next month or so is going to start doing this,” Hyman said. “People need to be more prepared to talk about the details of the law, but it’s also a good thing because it is getting people ready because when health plans are ready to actually sign people up, we want people to know about it, to be actually looking forward to the opportunity and to find the right way to enroll.”
One of the signatures of the health care overhaul, the exchanges aim to offer easy-to-understand, side-by-side comparisons of each plan’s costs and benefits. Vermonters who work in places with 50 or fewer employees and individuals and families who don’t get employer-sponsored health insurance will be invited to sign up for insurance coverage. All the plans will offer such basic services as checkups, emergency care, mental health services and prescriptions.
By the end of the year, people across the country without traditional health insurance will be able to sign up for coverage through state-sponsored exchanges including Vermont’s, to be known as Vermont Health Connect, or, in states that choose not to set up their own exchange, through one set up by the federal government.
While states that fought the federal health care overhaul efforts got a lot of attention, Vermont embraced it from the outset and hopes to go further. The state is in the process of setting up what would become the nation’s first single-payer health care system, due to be implemented in 2017.
Addison Independentreporter John Flowers contributed to this article.

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