Libertarian candidate for governor Dan Feliciano says Vermont Health Connect should be scrapped and the state should adopt the federal health care exchange.
Government is standing in the way of health care reform, Feliciano said. He also called Wednesday for the repeal of the state’s health care reform plan (Act 48), the elimination of the Green Mountain Care Board and a return to an open marketplace for health insurance.
Feliciano said Gov. Peter Shumlin’s goal of creating a single payer health care model in Vermont is “fantasy.”
Vermont has spent more than $100 million in federal money on the Vermont Health Connect website, which, while functional, remains unable to perform several critical tasks that were expected when the health exchange launched 11 months ago. The site remains inaccessible to small-group employers, and individuals cannot make online changes in their personal data, among other issues.
Feliciano said the state would save millions in ongoing operating costs by switching to the federal exchange, healthcare.gov. Oregon and Nevada have abandoned work on their own exchanges in favor of the federal site.
“Like many Vermonters, I have no confidence that Vermont Health Connect will ever be secure and operable,” Feliciano said at a news conference in the Statehouse. “We should migrate everyone on Vermont Health Connect to the federal exchange now, and provide Vermonters with more health plan choices and lower costs for insurance. That is what New Hampshire did, and it has worked very well.”
Under the federal Affordable Care Act, states had the option to create their own health care exchanges or go with the national program. Vermont chose to create its own website to maintain control over the coverage offered, among other reasons.
The federal exchange offers basic benefits, cost assistance, expands Medicaid eligibility and requires insurance plans to cover pre-existing conditions. It also ensures that people cannot be dropped from coverage when they become sick and cannot be denied coverage for any reason.
Unlike New Hampshire and others states using healthcare.gov, Vermont adheres to a community rating policy, which requires that all insurers charge patients the same rate for the same policies. That means insurers can’t offer different rates to different age groups or different rates based on health indicators, such as if someone is a smoker. Older and sicker people require more health care, and providing coverage to those groups drives up prices for everyone.
In addition to the federal subsidies, the Legislature kicked in with a state appropriation to reduce the out-of-pocket costs for low-income Vermonters.
Feliciano said the savings in operating costs achieved by replacing Vermont Health Connect could offset the loss of state premium subsidies. The Vermont Legislature has budgeted about $11 million to operate Vermont Health Connect in FY 2015, but since the feds pay the operating cost through January, that amount is to cover six months of operations (Jan.1-June 30).
He also promised to bring more insurers into the marketplace, which he said would lower costs through competition. Under Vermont Health Connect, only Blue Cross Blue Shield of Vermont and MVP compete for the metal-level plans required under the ACA.
Feliciano, an efficiency expert with health care experience, said state government could also save money by streamlining processes and lowering supply chain costs.
Feliciano faces Shumlin, Republican Scott Milne and three independent challengers in the Nov. 4 election.
Milne has said he hasn’t ruled out single payer as an option for Vermont, but has provided no specifics on his plans for health care policy if elected.
Correction: An earlier version of this story incorrectly said the state’s additional subsidy was part of Act 48.
