As the clock winds down on health care exchange open enrollment periods across the country, uninsured rates are getting a lot of attention. An out-of-state friend recently asked me, “How did Vermont cut its uninsured rate to 3.7 percent? That’s practically universal coverage!”
I pointed out that “universal” and “practically universal” are not the same thing; we still have work to do. As the executive director of the Open Door Clinic (ODC), I have had a front row view of how we’ve gotten this far. It boils down to three factors: strong state-based programs; friendly, accessible and knowledgeable staff; and a caring community.
Consider the story of a recent client here at the ODC. Names were changed to protect the privacy of individuals.
Patty comes from a family of dairy farmers. She works for an Addison County employer that recently made some changes in its benefit policy, which left some of its employees without health insurance. Patty was upset and angry, because she had received employer-sponsored insurance for many years and didn’t think she would be able to afford insurance on her own.
Enter Melanie Clark, a Vermont Health Connect navigator employed at the ODC. Melanie visited Patty’s workplace to talk to her and her co-workers about health insurance options. Patty said that, initially, stacks of health plan materials only left her feeling more confused and overwhelmed. Melanie then offered to meet one-on-one with anyone who wanted to talk about their personal situation or to get help applying for coverage. Patty jumped at the opportunity and scheduled an appointment.
Upon meeting with Melanie, Patty was thrilled to not only find a health plan that met her particular healthcare needs, but also to learn that this plan was going to cost less than her employer’s plan. She soon returned to the ODC with her brother Andy so that he too could find health coverage.
“My brother is a dairy farmer and, like all dairy farmers, he’s hurting because the price of milk is terrible,” Patty says. “They work seven days a week and are more at risk of injury than most people. My brother doesn’t have health insurance and didn’t know he qualified for help.”
“It was 7 o’clock on a cold, rainy night, but when we walked into the Open Door Clinic and talked to Melanie, you would have thought it was noontime on a sunny day,” Patty said. “When my brother found out he could afford health coverage, he was so thrilled I think he wanted to hug Melanie.”
Vermonters live in a state that the Commonwealth Fund recently ranked number two in the nation in terms of health insurance access and affordability. Between expanded Medicaid, federal tax credits, and Vermont-based programs to bring down the cost of health insurance, farmers and other Vermonters are now finding that they can afford health coverage.
Andy was so happy with his experience that he brought his son in the next week. Andy’s son, who also works on the farm, was accompanied by his girlfriend. She’s a cook in a local restaurant that doesn’t offer health insurance. Before leaving, she made an appointment for herself and her sister.
To recap, one Vermonter came in the door concerned about her loss of health coverage. Five individuals came away enrolled in health insurance plans that matched their needs and budgets. Five individuals now understand terms like “deductibles” and “out-of-pocket maximum.” They now know that Vermont Health Connect and its assisters are accessible and helpful.
This is the type of ripple effect that results when our state and federal governments build programs to make coverage more affordable and provide trained assisters to help our residents navigate the system and make informed decisions. The power of Vermont’s strong communities, personal networks and word of mouth has helped our state cut its uninsured rate below 4 percent, and we are hopeful that it will continue to drive down the number of uninsured persons until every resident has the health, well-being and peace of mind that comes from being covered.
It’s worth noting that Melanie Clark is a real-life super-woman, and she’s not alone. Vermont Health Connect assisters work in community organizations and social service agencies across the state, providing a physical presence and source of help in all of Vermont’s 14 counties. Patty also says that, although she had a fairly long wait when calling Vermont Health Connect last week, the customer support representative on the phone was friendly and answered all of her questions.
The ripple effect is not over. Patty says that her son has several friends in their late 20s who work as carpenters and don’t have health insurance. She’s going to let them know that Sunday is likely their last chance to sign up for health insurance in 2016.
If you have any uninsured family, friends or neighbors, please encourage them to call Vermont Health Connect by Sunday.
Open Enrollment ends Jan. 31. The federal fee for not having insurance goes up in 2016 and, for many Vermonters, will cost more than a basic health plan.
Do you know anyone in your community who still needs insurance? Please ask them to call 1-855-899-9600 or visit VermontHealthConnect.gov to learn more. The toll-free number will be open on Saturday, Jan. 30, from 8 a.m. to 4:30 p.m., and Sunday, Jan. 31, from 10 a.m. to 5 p.m.
Heidi Sulis is the Executive Director of the Open Door Clinic in Middlebury.