Rep. Patti Komline, R-Dorset, and several colleagues want Vermont to consider switching to a supported state-based marketplace (SSBM), a new variation of the state-federal partnership option for health exchanges.
“What this enables you to do is use as much of the federal exchange as you want,” Komline said. “We can control the plans that we’re offering, but when it comes to handling the IT, we can call on healthcare.gov to do that.”
She was joined by Reps. Heidi Scheuermann, R-Stowe; Rep. Jim Condon, D-Colchester; and Rep. Adam Greshin, I-Warren, at a Thursday news conference.
“Vermonters deserve a functioning insurance portal, and they don’t have that yet,” Condon said.
The group will introduce a bill calling on the Agency of Administration to produce a plan to move to the new type of Affordable Care Act marketplace by the end of March.
There is little information on the SSBM model, and it does not appear the federal Centers for Medicare and Medicaid Services has issued formal guidance on how the arrangements work.
Komline gave the media an article posted to the benefit management company HighRoads website offering some detail. The article doesn’t have a byline and is attributed to a HighRoads contributor.
According to the article, Oregon and Nevada aren’t being asked to pay a 3.5 percent user fee on premiums sold through healthcare.gov, and CMS will allow them to retain 100 percent of their payer assessments “in essence allowing them to use the federal technology at no cost.”
State officials had little information about the SSBM model. Miller said he had a conversation several months ago with a CMS official about the alternative, but could not recall the specifics.
Moving to an SSBM could be viable, he said, but there are many unanswered questions. Miller said he’s willing to look at all options for improving Vermont Health Connect. The state would still need to operate the back end of its exchange, because it is the state’s Medicaid portal as well.
It’s also unclear if going to an SSBM would allow Vermont to retain its own additional subsidies. There is also the question of whether an SSBM would be impacted by the King v. Burwell Supreme Court case that could prohibit states using the federal exchange from offering subsidies at all — though a recent Oregonian newspaper article suggests it would not.
Part of the reason for introducing their legislation is to have those questions answered, Scheuermann said.
