MONTPELIER — State officials say the ground-up construction of a new health care bureaucracy is on track for its Oct. 1 debut, when the launch of Vermont Health Connect will change the way about 100,000 Vermonters purchase health insurance.
Assurances from Cabinet-level administration officials Thursday came as they made public for the first time an outside review that identifies numerous “risks” associated with the creation of the online health care exchange, including delays that could cost the state some federal funding.
But Mark Larson, commissioner of the Department of Vermont Health Access, says the concerns highlighted in the new report have been resolved or are on the verge of being so. And Vermonters, according to Larson, will soon enjoy the fruits of an enterprise into which nearly $200 million has already been poured.
“We are on track for a successful launch of Vermont Health Connect,” Larson said. “We’re on track to offer Vermonters health coverage in an accessible, straightforward way starting Oct. 1.”
The health care exchange is a product of the federal Affordable Care Act and offers consumers an online portal at which they’ll be able to conduct side-by-side comparisons of competing health insurance plans and enroll in the policy of their choosing.
While federal law requires all states to have an exchange, the Shumlin administration and the Legislature have chosen to make it a centerpiece of the health insurance marketplace and ensure its widespread use by requiring individuals and businesses with 50 or fewer employees to purchase their insurance through it.
The same outside consultant that produced the critical report, BerryDunn, said the scale of the health care exchange — and the “integrated eligibility” project accompanying it — is “an unprecedented undertaking” for Vermont.
Larson said Thursday the state will fulfill its pledge to have the exchange apparatus in place by October. And he said the focus now is on making sure Vermonters know how to use it. A “first batch” of 172 exchange “navigators” finished their training last week and will now help individuals and businesses make their way through the maze of options available to them.
In its search for navigators, Larson said the state has looked to established organizations — running the gamut from the Vermont Chamber of Commerce to the Association of Africans Living in Vermont — so as to tap into existing networks through which information can be transmitted.
The state will spend $2 million on contracts involving 250 navigators and $6 million on paid media in its bid to get the word out to Vermonters.
Peter Sterling, director of the Vermont Campaign for Health Care Security, one of the organizations that won a navigator contract, said the use of existing groups to conduct grass-roots outreach is a sound strategy for optimizing consumer enrollment in the exchange.
“You can’t wait for low- and middle-income people to come to you. They will not do it. Their lives are busy, they have other things going on,” Sterling said. “So the fact we have a navigator effort that’s community based, and meets people where they normally congregate, that is the key to success in getting people to enroll.”
Aside from offering apples-to-apples comparisons of competing insurance plans, the exchange will also offer eligible Vermonters substantial financial help, mostly in the form of premium assistance and federal tax credits. An online subsidy calculator, available at healthconnect.vermont.gov/tax_credit_calculator, will tell residents exactly how much they can expect to pay for insurance in the exchange.
The development of the exchange hasn’t been without its challenges. Cost overruns forced the state to seek an additional $42.7 million from the federal government, a request that was fulfilled earlier this month. At a hearing Tuesday, key lawmakers expressed concern about the mounting costs and the extent to which Vermont taxpayers would be left holding the bag when the flow of federal money subsides.
The BerryDunn review pegs total costs for the exchange and integrated eligibility projects over the next five years at more than $427 million. Larson and Robin Lunge, the director of health care reform for the Shumlin administration, said they agree with that estimate, and that federal contributions will limit state obligations to $18 million a year — a figure lawmakers Tuesday warned Larson they would hold him to.
The BerryDunn consultants wrote in their report that the nearly $500 million enterprise will “not result in a tangible positive return on investment in the first five (or 10) years after deployment.” Lunge, however, said the benefits of the new system aren’t necessarily captured in a conventional return-on-investment equation.
“How do you do return on investment for consumer experience?” Lunge said. “You can’t quantify the consumer experience into dollars and cents, and both with integrated eligibility and Vermont Health Connect, a big component … is improving the ways Vermonters access health coverage.”
Larson said it’s important to note that the “investment” is being underwritten mostly by the federal government.
“We want to reinforce the fact that we are very, very appreciative of the fact that the federal government is making a substantial investment in all of these projects to make the investment by Vermonters very, very modest, to be able to achieve these very important goals,” Larson said.
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