WINOOSKI โ€” Lobbying groups that support universal health coverage are proposing to expand the Dr. Dynasaur program to Vermonters of all income levels up to age 26.

A broad coalition of advocacy groups, represented by the Vermont chapter of Main Street Alliance, a business group, and the Vermont NEA, a teachers union, presented the plan at a news conference Wednesday at Mule Bar in Winooski.

Dubbed Dr. Dynasaur 2.0, the proposal would provide universal, low-cost health care to all Vermonters who are young enough to be covered on their parentsโ€™ health insurance under the Affordable Care Act. Premiums would be under $1,000 per year, and there would be no copays.

Advocates want the Legislature to commission a study in 2016 that would report on financing options for Dr. Dynasaur 2.0โ€”including how to raise the reimbursement rates Dr. Dynasaur pays to primary care physicians and pediatricians so they could afford to treat the influx of enrollees.

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What is Dr. Dynasaur?ย 

A health insurance program unique to Vermont that covers low- and lower-middle income children with no out-of-pocket costs and low, income-based premiums. The program started in 1989 and predates the 2013 Medicaid expansion for adults under the Affordable Care Act.

In July, there were 62,584 Vermont children on income-based Medicaid programs, including Dr. Dynasaur.

The Dr. Dynasaur 2.0 proposal would add another 120,000 people, including college students and recent graduates, to the state health insurance program.

There are roughly 205,000 Vermonters of all ages who receive some sort of Medicaid benefit as of October.

The program could result in a 2 percent increase in the payroll tax, according to information provided by Peter Sterling, a longtime advocate of a single payer health care system in Vermont.

The groups have backing from House Speaker Shap Smith, D-Morristown, who dropped out of the governorโ€™s race in November to help his wife battle cancer. Smith supports the feasibility study.

โ€œI think that building on one of the most successful programs in the history of the state and expanding public health and health care benefits to everybody under 26 is something worth pursuing,โ€ Smith said.

โ€œAt the end of the day, we need to know that it would cost us less than what weโ€™re doing now, and I think itโ€™s worth exploring,โ€ Smiths said. He said he would work with leadership in the House to help get a study funded, likely through the appropriations bill.

Shap Smith
House Speaker Shap Smith. File Photo by Elizabeth Hewitt/VTDigger

โ€œMy view is that the current financing system for health care is completely broken, and I can tell you that as somebody thatโ€™s dealing with health care bills right now, itโ€™s just absolutely incomprehensible and is broken,โ€ Smith said. โ€œTo the extent that we can expand a system thatโ€™s already successful, I think it makes sense.โ€

Smith said expanded health care coverage is a potential โ€œeconomic development tool.โ€ Right now, so-called Cadillac health insurance plans, which many teachers and state employees use, will be subject to an excise tax in 2018. The tax would kick in for family plans that cost more than $27,500 and individual plans that cost $10,200.

Lindsay DesLauriers, the executive director of Main Street Alliance of Vermont, said private insurance plans regulated under the Affordable Care Act cost too much money, and the Dr. Dynasaur 2.0 proposal would be cheaper for businesses and employees.

โ€œIf itโ€™s successful and Vermont moves forward with Dr. Dynasaur 2.0, then itโ€™s going to make Vermont a healthier and a more affordable place to live,โ€ DesLauriers said. โ€œIt will make family plans in Vermont obsolete.โ€

The most popular health insurance plan offered by Vermont Health Connect is a Standard Silver plan through Blue Cross Blue Shield, which covers 70 percent of total health care costs, according to Sean Sheehan, the spokesperson at the Department for Vermont Health Access.

The silver plan has a $2,000 deductible for a single person and a $4,000 stacked deductible for a family, if they donโ€™t qualify for special cost-sharing programs. Prescription drug costs are capped at $1,250 for an individual and $2,500 for a family. Other out-of-pocket costs are capped at $5,600 for an individual and $11,200 for a family.

According to handouts from the Dr. Dynasaur 2.0 campaign, a family with two adults and two children earning $100,000 per year currently pays $22,140 per year for a family platinum plan, and that doesnโ€™t include out-of-pocket costs.

The campaign estimates that letting the children enroll in Dr. Dynasaur regardless of income would save families $5,664 per year on premiums.

A family with one adult and one child earning $49,000 per year would be just over the current Dr. Dynasaur income limit and would save up to $4,692 on premiums. A single 25-year-old would pay up to $720 in Dr. Dynasaur 2.0 premiums.

Wes Hamilton is the co-owner of Mule Bar in Winooski, the Three Penny Taproom in Montpelier and Mad Taco in Montpelier and Waitsfield. He doesnโ€™t offer employees health insurance, but he supports Dr. Dynasaur 2.0 even if it means higher payroll taxes.

โ€œIโ€™m a huge proponent of universal, single-payer care,โ€ Hamilton said. โ€œEvery business pays a water and sewer bill, and we just include that cost in the price of our products just like every other business. If everybody has to do it, then itโ€™s simple. If everybody doesnโ€™t do it then Iโ€™m probably going out of business because the price of my burger is higher than everyone elseโ€™s.โ€

The following groups support a study of the Dr. Dynasaur 2.0 proposal: AARP Vermont, Vermont League of Cities and Towns, Planned Parenthood of Northern New England, Vermont NEA, Main Street Alliance, Voices for Vermontโ€™s Children, Vermont Businesses for Social Responsibility, American Federation of Teachers/United Professions of Vermont, Professional Firefighters of Vermont, VPIRG, American Heart Association, the Vermont State Employees Association and the American Cancer Society.

Twitter: @erin_vt. Erin Mansfield covers health care and business for VTDigger. From 2013 to 2015, she wrote for the Rutland Herald and Times Argus. Erin holds a B.A. in Economics and Spanish from the...

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