Making the switch: State insurance programs will end
Carrie Riker of Worcester juggles two jobs, neither of which offers her health insurance. For the past five years, she has been covered by Catamount Health, a state program.
Catamount Health and another state-subsidized insurance, Vermont Health Access Program, have been scheduled to end Dec. 31, so Riker and 50,000 other Vermonters who have been covered by these two programs face change.
The change is prompted by the federal health reform law that called for the creation of online health insurance marketplaces where people could apply for federal tax credits and other financial assistance that would help reduce the cost of their medical coverage.
The federal law also allows states to expand Medicaid, a subsidized health insurance program for low-income children and adults that is funded jointly by federal and state dollars.
Vermont officials estimate 30,000 of today’s Catamount and VHAP clients will qualify for coverage under Medicaid, because the income level that determines eligibility was increased under the 2010 federal Affordable Care Act. The state has notified the Vermonters on Catamount and VHAP who are eligible for Medicaid that they need do nothing for the new coverage to take effect Jan. 1.
Riker and about 19,000 other Catamount and VHAP clients earn too much to qualify for Medicaid. They have to find new coverage using Vermont Health Connect, the state’s online health insurance marketplace for individuals buying insurance on their own and small employers selecting plans for their workers.
Vermont Health Connect, however, has had a rocky launch. Similar to its federal counterpart, the Vermont Health Connect website has been plagued with technical glitches that frustrate many of those trying to sign up for insurance.
Riker hit some of those trouble-spots but said she also found the questions on the application confusing, such as what constituted income. And running between jobs in Morrisville and Plainfield left her without a lot of spare time to devote to sit in front of a computer or on the phone trying to complete her application.
Still, when asked Thursday, Riker proclaimed, “I did it.”
She ended up going to the People’s Health and Wellness Clinic in Barre, where a trained “navigator” answered her questions and helped her complete the application. The state distributed $2 million to 18 organizations throughout the state, including this clinic. The groups were directed to designate “navigators” who would reach out and provide assistance to the 100,000 Vermonters who must buy their 2014 health insurance through Vermont Health Connect.
Riker said the navigator at the Barre clinic helped her understand the differences among the 18 health insurance plans offered on Vermont Health Connect: “It is very confusing to know which is the best one.”
She said she would have picked the wrong plan without help from a navigator: “They weren’t advocating for any particular plan, but they were interpreting the charts.”
Riker has qualified for a federal tax credit to help her pay her monthly premium, plus some state aid to help with other out-of-pocket expenses. She said she will pay slightly more than she did under Catamount.
With her selection made, all that is left is for the state to send her a bill, which she will need to pay by Dec. 15 to have coverage under her new plan Jan. 1.
Many are challenged
Lynn Raymond-Empey, executive director of the Vermont Coalition of Clinics for the Uninsured and a “navigator” for Valley Health Connection in Bellows Falls, testified before the House Health Committee last week regarding her observations about Vermonters on Catamount and VHAP who must now buy insurance through Vermont Health Connect.
“For many of them, their premiums, cost sharing and coinsurance amounts are going up,” Raymond-Empey said.
“In addition, there is a sharp insurance literacy curve. Many of them do not fully understand the concepts of deductible and co-insurance. Their current experience really only involves paying premiums and copays,” she added. “Nobody should feel they are naive. This is a big learning curve for all of us.”
She noted, too, that like Riker, many Catamount and VHAP clients found that discerning the differences among the plans “extremely stressful for them.”
And then there are the website’s troubles.
“I wouldn’t call them glitches,” Raymond-Empey said. “With all the press about the website, it is a very negative vibe. I think it has probably scared a lot of people off.”Alternative offered
After defending Vermont Health Connect for a month, Gov. Peter Shumlin acknowledged a week ago that progress on remedying the website’s problems had been too slow. He announced he enlisted the help of the two insurance companies offering plans on the website to give Vermonters alternatives.
He also said the state would offer Catamount and VHAP clients an alternative: Their coverage would be extended automatically to March 31 unless they signed up for a new Vermont Health Connect plan by mid-December.
“We will not discontinue coverage for those currently enrolled,” Mark Larson, commissioner of the department that oversees Vermont Health Connect, Catamount and VHAP, said Friday during a media briefing on the new alternatives.
Extending the state programs might have financial consequences for the state, Larson told the House Health Care Committee last week. Friday he said he was talking with federal officials to win approval for continued sharing of subsidies for VHAP and premium assistance provided to some on Catamount.
State officials will reach out to assist VHAP and Catamount clients with enrolling on Vermont Health Connect in order to minimize how many of the 19,000 making the switch remain on those programs after Jan. 1.
Two reminder letters already have been sent. Larson said the state plans to call every Catamount and VHAP client who fails to enroll by Dec. 1 in one of the Vermont Health Connect plans.
“We continue to encourage Vermonters to use Vermont Health Connect,” he said.
Raymond-Empey of the uninsured clinic coalition said reaching and enrolling those 19,000 would be one of the measures of whether Vermont Health Connect improves access to comprehensive, affordable health care.If the state misses the target with these two groups, she said, “The number of uninsured is going to go up instead of down.”
