• What to expect now
     | September 07,2013

    As a Navigator working with the state to educate Vermonters about the exciting changes coming to our health care system, I hear a lot of confusion about Vermont Health Connect, Vermont’s health benefit exchange. There are 200 Navigators working in all parts of the state. We have been specially trained to provide accurate information and help Vermonters understand their options for getting coverage through Vermont Health Connect. Because of the state’s large investment in Navigators, Vermonters will have plenty of help enrolling in coverage. And there will be new and easier ways to enroll — through the Vermont Health Connect website, over the phone, through the mail, or with in-person assistance.

    Vermont Health Connect is the online marketplace that begins Oct. 1 where Vermonters without access to affordable employer coverage and small employers with up to 50 full-time employees can buy health insurance and enroll in public programs like Medicaid and Dr. Dynasaur. Vermonters will have the choice of 20 private health plans offered by BlueCross Blue Shield and MVP that are heavily regulated by the state.

    Choosing a health insurance plan will be much easier than it is now. There will be no more guessing about what benefits are covered. All plans will cover the same comprehensive set of services, including primary and specialty care, hospitalization, prescription drugs, mental health and substance abuse, and dental and vision services for children. The differences among the plans are in the cost — premiums and out-of-pocket costs like deductibles, co-payments, etc. Information about the plans will be in a standardized format so it will be easy to compare plans. Vermonters will choose the health plan with the premium amount and level of out-of-pocket-costs that best fits their health care needs.

    Changes are also coming to some of Vermont’s public programs. The VHAP and Catamount Health programs will end on Dec. 31. For thousands of Vermonters this means enrolling in Medicaid, which is free. Financial assistance through reduced premiums and out-of-pocket costs will be available to Vermonters with annual incomes up to about $46,000 for an individual and $94,200 for a family of four.

    While many of the changes Vermont Health Connect offers are a step in the right direction, more long-term steps to control health care costs and provide truly affordable coverage are happening simultaneously.

    Even as it focuses on getting Vermont Health Connect up and running, the state is preparing to move to a universal coverage, single-payer health care system. In a single-payer system a relatively modest amount of taxes will replace some of the billions that we currently spend on private health insurance. The projected savings for the first year of a single-payer system are projected to be $35 million, and increase over time. Only when we switch to a single-payer system will we be able to ensure that everyone has access to truly affordable and comprehensive health care.

    Donna Sutton Fay is a Navigator for the Vermont Campaign for Health Care Security Education Fund.

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