State to continue to push Green Mountain Care

Rep. Dakin reassures as
Supreme Court decides federal law

By Stephen Seitz

Whatever the U.S. Supreme Court decides to do about health care, the state will do its best to go forward with its Green Mountain Care plan, according to state Rep. Leigh Dakin.
Dakin gave her assessment Monday, April 2 at the Fullerton Inn, during a breakfast sponsored by the Okemo Valley Regional Chamber of Commerce.
The Supreme Court is deciding on whether the federal Patient Protection and Affordable Health Care Act is constitutional. The court could uphold the law as is, strike down part of it or scrap the law altogether.
“If they rule only on the individual mandate, there will be an effect,” Dakin said. “If they rule on the entire Affordable Care Act, that will have broader effects. We don’t know how it will affect us. But we may have to step back and make some changes.”

“If they rule only on the individual mandate, there will be an effect. If they rule on the entire Affordable Care Act, that will have broader effects.”

Rep. Leigh Dakin

To spur the creation of Green Mountain Care, which aims to bring insurance to every Vermont resident, the state’s congressional delegation introduced legislation in January 2011 that would allow Vermont to apply for a waiver to create a state health care system in 2014 rather than 2017 as provided for in the Affordable Health Care Act.  President Obama soon announced his support for the waiver.
Dakin said Vermont’s quick action gave the state a chance to completely overhaul health care.
“One thing we’re feeling good about is that we jumped on it right away,” she said. “This was our opportunity to start over again. It will happen in some form. Act 48 set the framework.”
The end result is not guaranteed, she added.

Some of the federal components, Dakin said, are already in place: coverage for pre-existing conditions, more coverage for preventive care and keeping young people on their parents’ insurance until age 26. The ability to take your health insurance with you when you change jobs is also part of Green Mountain Care.
“Green Mountain Care,” Dakin said, “now has a five-member board studying how to make it work. They’ll develop a system to be phased in over five years. If something doesn’t work, we can make changes along the way. We’ve made the foundation. Now we want the walls to be strong and tight.”
Dakin, who represents Chester, Andover, Baltimore and part of North Springfield, said her committee – the House health care committee – is working on creating an insurance exchange, a pool of insurance plans from which individual buyers and employers could choose.
“Employers can access the exchange to provide insurance,” said Dakin, “or they can turn their employees loose and let them enter the exchange on their own. They can access federal pre-tax credits to pay for their premiums and apply for subsidies to pay for deductibles and out-of-pocket costs. We’re hopeful it will be a win-win.”

Under the current federal law, Dakin said, “By 2016, all states will have to have an exchange,” adding that Vermont residents could pick from as many as 16 plans. “Individuals and employers can choose the plan” that fits best, she said.
While the federal government defines a small business as one with 100 employees or fewer, Dakin said it would serve Vermont better to define a small business as one with 50 employees or fewer.
“If you include the 40,000 residents who can’t afford insurance at all, we hope to cover an additional 90,000 people,” she said. “Employers will still be able to continue providing health care to their employees.”
According to a 2009 U.S. Census Bureau report, 57,000 Vermont residents were not covered by any insurance at all in 2008, the most recent year complete figures are available. While many residents have insurance, Dakin said, many have such high deductibles and co-pays that their coverage is ineffective. Green Mountain Care is meant to help them, as well.

Lynne Reed, co-owner of Misty Valley Books, said there was no way for the individual consumer to compare line-item costs of health-care services.
“In the old days, you just went to the doctor and paid the bill,” she said. “But with this system, nobody knows what these things cost. I asked my doctor’s secretary. She didn’t know. The doctor didn’t know.”
Ludlow insurance agent Sharon Bixby wanted to know how Worker’s Compensation would be affected by Green Mountain Care. Dakin said she would look into it. “That still hasn’t been settled,” Dakin said.

“In the old days, you just went to the doctor and paid the bill. But with this system, nobody knows what these things cost. I asked my doctor’s secretary. She didn’t know. The doctor didn’t know.”

Lynne Reed
Misty Valley Books

Massachusetts resident Dan Verrico, who recently bought a home in Vermont, said that he has lived under the health insurance system enacted under former governor and current Republican presidential candidate Mitt Romney.
“You’re defining a small business as having 50 or fewer employees,” he said. “But many companies are a company of one. Would my company be considered a group of one?”
“Yes,” Dakin said.
Verrico said that the Massachusetts system hadn’t saved a lot of money.
“If someone opts out, they’re penalized by the state,” Verrico said. “They’d rather pay the $100 per month penalty than buy a plan. Businesses are still paying from 11% to 13% over the last five years, just like before.”
More information on Green Mountain Care can be found at www.greenmountaincare.org. The U.S. Census report can be found here.