The question of whether Vermont Health Connect is expanding health care insurance coverage and reducing the number of uninsured Vermonters will remain unanswered for a while.
State officials say it would be premature to parse the enrollment data collected through the exchange, and results of a survey by the Department of Financial Regulation won’t be ready until January 2015.
That isn’t soon enough for some advocates who would like to see uninsured estimates before the next open enrollment period, which begins in mid-November.
Peter Sterling, director of the advocacy group Vermont Leads, says it makes sense for the state, navigators and insurance companies operating in the exchange to have information about who remains uninsured this summer — before the open enrollment period for health insurance sign-ups at the end of the year.
Among other things, advocates say having some idea about who remains uninsured would help them focus their outreach.
“Waiting until the fall is like a political campaign waiting until the day before the election to release its only poll,” he said.
There are a number of reasons that conducting the earlier survey wouldn’t be practical, according to the Department of Financial Regulation.
Dale Schaft, a spokeswoman for the department, says the department contracts with a third-party vendor to conduct the Household Insurance Survey and that process can’t be accelerated.
It’s best to conduct the survey at the same time each year to ensure consistency, Schaft said. The department chose the fall because response rates are typically better at that time of year, she added.
Sterling argues that the Department of Financial Regulation has known it would be conducting the survey for close to a year and could have moved up the contract deadlines. It could also increase the number of calls to allay concerns about adequate survey response rates, he said.
The household insurance survey was first conducted in 2000 and isn’t on a set schedule, Schaft said. Subsequent surveys have taken place in 2005, 2008 and 2012.
In 2012, the survey found roughly 42,000 Vermonters were without health insurance or 6.8 percent of the population.
Since then, the state has created Vermont Health Connect, an online marketplace that showcases health care plans that meet new actuarial value requirements under the Affordable Care Act. In Vermont, individuals and businesses with 50 or fewer workers were required by law to purchase insurance through the exchange. But because Vermont Health Connect website was dysfunctional, most companies had to buy the plans directly through their insurer.
Someone who is new to the individual market or Medicaid and obtained coverage through the exchange isn’t necessarily previously uninsured. Their employer could have dropped coverage; they may have been on VHAP or Catamount for all or part of the previous year; in addition, they could have been self-employed, lost or gained employment or divorced a spouse with employer-sponsored coverage.
Capturing people’s insurance status when they signed up for coverage didn’t happen, and may have been difficult to capture even if the website’s launch wasn’t rushed. The application asked enrollees if they currently had health insurance, when respondents said they did they were prevented from completing the online sign-up process.
The dearth of official figures has fueled partisan speculation, with Republicans suggesting at times this year that the exchange would actually swell the ranks of the uninsured. They contend that it would help the state better target its outreach and maximize enrollment of the state’s remaining uninsured population.
The Department of Vermont Health Access, which operates Vermont Health Connect, intends to do its own survey work in the coming months, though it has not ironed out the details, spokeswoman Emily Yahr said.
However, its surveys will focus on plan selection and customer satisfaction and won’t attempt to parse whether Vermont Health Connect has expanded access to coverage, she said.
