Scheuermann, Komline call for change to allow individuals on VHC to enroll directly with insurers

Two state representatives called on Gov. Peter Shumlin to allow Vermonters to purchase health insurance outside the state’s troubled health care exchange and instead buy it directly from insurance carriers.

Ongoing problems with Vermont Health Connect, the state’s online health insurance exchange, are having “a disastrous effect” on thousands of Vermonters’ access to care, said Rep. Patti Komline, R-Dorset.

Rep. Patti Komline, R-Dorset, claps during Gov. Peter Shumlin's 2014 budget address. Photo by Roger Crowley

Rep. Patti Komline, R-Dorset, claps during Gov. Peter Shumlin’s 2014 budget address. Photo by Roger Crowley

Rep. Heidi Scheuermann, R-Stowe, joined Komline in calling on the governor to allow people who purchased coverage on the exchange last year to renew their insurance directly with carriers, and allow new entrants to do the same.

Rep. Heidi Scheuermann, R-Stowe, a member of the House Committee on Commerce and Economic Development. Photo by Roger Crowley/for VTDigger

Rep. Heidi Scheuermann, R-Stowe, a member of the House Committee on Commerce and Economic Development. Photo by Roger Crowley/for VTDigger

Making the exchange mandatory for people in the individual market was a mistake, they said, and goes beyond what other states that chose to build their own exchanges require.

“Mr. Governor, Vermonters are hurting. It is time now to admit that was a mistake, and allow those people who are stuck in this abysmal system to work directly with their insurance carriers if they so choose,” said Scheuermann, who briefly entertained a run for governor earlier this year.

The pair acknowledged that people receiving Medicaid or subsidies must use the exchange to receive those benefits, but argue that people paying full freight should be able to deal directly with insurers.

The vast majority of Vermont Health Connect users are on Medicaid, receive subsidies or may have a change in income that would qualify them for subsidies, said Lawrence Miller, chief of Health Care Reform for the Shumlin administration.

“Solving a problem for the minority of people that don’t have a subsidy hasn’t been our priority so far,” Miller said.

At this point all options are on the table to improve the ailing system, he said, but Miller’s understanding when he joined the effort to fix Vermont Health Connect was that the carriers “did not have the appetite” to direct enroll individuals.

He was not sure that it would be feasible for them either, but said it’s something the state would look into.

“I doubt it’s that simple,” he said.

In their joint statement Scheuermann and Komline wrote, “approximately half of those Vermonters who are in limbo would not qualify for these subsidies,” and could more easily manage their plans through insurers.

There are 33,000 people who purchased commercial insurance in the individual market. More than half receive subsidies, according to state officials. There are more than 14,000 people who need to make corrections to their account information or changes to their coverage. Twenty percent of those are Medicaid beneficiaries, making it improbable that half of the people in limbo are paying the full cost of their plan.

Even if it’s a smaller number, it still makes sense to allow individuals to purchase directly from carriers if they elect to do that, Komline said in a follow-up interview.

“Say it’s only 5,000 people — say it’s 3,000 — if they choose to leave the exchange, this would let us focus our efforts on vulnerable populations,” she said.

In addition to the 14,000 people who need corrections or changes, there are roughly 22,000 Medicaid beneficiaries that have not renewed their coverage and will eventually need to do so through Vermont Health Connect.

Because some of those Medicaid beneficiaries may have tried to use the website, but entered information incorrectly, there could be some duplication in those two groups.

The Vermont Republican Party also issued a statement Tuesday calling for the governor to “fire CGI” and replace Agency of Human Services Secretary Doug Racine and Department of Vermont Health Connect Commissioner Mark Larson.

Shumlin said recently he does not intend to make any changes in leadership.

The governor said it is his responsibility to see that contingencies are in place, so that Vermont Health Connect is working smoothly by open enrollment in November when thousands of new users and tens of thousands of existing users will flood the system.

Morgan True

Comments

  1. Kerry Comollo :

    “Solving a problem for the minority of people that don’t have a subsidy hasn’t been our priority so far,” Miller said.

    OUCH!! I fall into that minority and know that we have not been anyone’s priority.

    I wound up having to go into the pool and purchasing a health care policy that is less than half as good as the one I had before. And it ultimately costs me substantially more.

    A prescription I used to pay $3 for is now $60.
    When I do the math – it would cost me less to have NO insurance than to have the policy I got pushed into.

    When are those of us willing to obtain insurance (at a fair price) going to be your priority, Lawrence Miller??????

    The system is inoperable at best, but borders on being toxic. I could not name ONE person that wound up with better insurance at a better price…who is running this system – VT or the insurance companies?

    • Jimmy Fordham :

      Please back up your statement with facts. How much did u pay before..did your employer pay your premium? Don’t just make statements unless you provide facts.

  2. Margot Page :

    I don’t have a subsidy but feel that my issues with VHC–coverage mistakenly terminated, prescription difficulties, and now mysterious missing dental coverage even tho I’ve been paying the premium all along–are as important as anyone else’s. I never understood why we were mandated to go thru the ill-conceived VHC in the first place. What a mess! I can’t imagine the difficulties others are going through trying to advocate for themselves with this overloaded, incompetent system. I love Vermont but this idea was B A D in details and execution!

  3. Chris Lewis :

    At a recent meeting for employers in Montpelier, I heard many horror stories from Vermonters dealing with the exchange. Three of which were sitting at my table.

    And there was Mr Costa, up-front stating that all was going well and we shouldn’t believe all the negative press.

    It was both humorous and alarming how detached this administration has become from Vermonters.

    • Jimmy Fordham :

      So you weren’t there…you heard. So much credibility.

      • Chris Lewis :

        I was there Jimmy. Recheck your records.

        Perhaps you are confused what the word ‘credibility’ means. I would expect as much from anyone who has a hand in this mess.

      • Jon Corrigan :

        Your comment is exactly that which one would expect from a state worker. Good job.

    • Jamey Carothers :

      Thats interesting. My family and I signed up and had no problem with the website or the policies whatsoever. In fact, we have a BCBS policy that we are paying about $300 a month less than we did the last time we used BC- about 7 years ago. The only thing I wish the website would fix is to give us the ability to make automated payments through the site on a monthly basis. I understand that is coming soon. Lastly, I have had to call VT Connect 3 or 4 times during this sign up to ask a few questions. Every person I spoke with was extremely polite and if they didn’t know the answer, they found someone who did.

  4. Dan Carver :

    Facts:
    New Hampshire – population 1.3 million.
    ACA implementation cost – $ 8 million. (final cost per person $ 6.15)
    Project status – complete.

    Vermont – population 0.66 million (50% of NH)
    ACA implementation cost – estimated at $ 171 million ($ 72 million spent to date; much more spending to come – estimated final cost per person $ 259.09)
    Project status – significantly behind schedule and over spent.

    Is there really anything more to say? It’s time to throw in the towel. Hit the Reset button. Pay the $ 8 million and Move Forward!

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