The House Health Care Committee passed legislation last week that would allow individuals to purchase plans offered on the Vermont Health Connect exchange directly from participating insurers.
Vermont is the only state that requires people purchasing health insurance in the individual market to go through the exchange. The bill, H.487, doesn’t create a market outside the exchange, and people without employer-sponsored insurance would still be limited to the plans it offers. Some lawmakers have said they would like to see an off-exchange market.
People who would buy insurance directly from the carriers would not be eligible for subsidies. That’s roughly 12,000 people currently, and administration officials say they expect only several thousand to change their plan next year. Those people looking to switch would be able to do so by buying coverage directly from insurers.
Lawmakers are eager to find ways to eliminate headaches associated with the exchange.
Blue Cross Blue Shield of Vermont and MVP Health Care have said they support the new provision.
“We see it as another contingency to try and take care of that individual population,” said Cory Gustafson, director of government and public relations for Blue Cross.
Gov. Peter Shumlin announced a similar contingency right after the exchange launched that would allow businesses in the small group market, who were originally expected to use the exchange, to enroll directly with the carriers. The website still can’t serve small businesses and companies with 50 or fewer employees continue to enroll with the carriers. Like the small business contingency, direct enrollment for individuals would require federal approval.
Gustafson said that even if only a small number of people use the individual direct enrollment option, it will still have ancillary benefits for the rest of the individual market.
“It helps everyone else in that this group’s changes won’t have to go through the VHC system,” he said. Changes to applications are currently made manually. People who buy insurance directly through insurers can avoid that laborious process.
The committee bill passed the bill with a 9-0 vote late Friday, just making the crossover deadline, which required policy bills to be approved the committee of jurisdiction by the end of last week.
The bill has several other provisions as well, including an extension through 2018 of confidential malpractice mediation, requirements for reporting by the Blueprint for Health on its return-on-investment and a directive requiring the Green Mountain Care Board to consider the validity of differential payments from insurers to hospital and non-hospital-employed doctors, as well as other payment reform issues.
