Federal Regulations Could Weaken Health Care Exchange

02/27/12 5:50PM By Bob Kinzel
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(Host) State officials are concerned that the federal government will enact regulations that could undermine the competitive nature of Vermont's new health care exchange beginning in 2014.

VPRs Bob Kinzel reports.

(Kinzel) A key part of the health care bill passed by the House last week is the creation of a consumer marketplace exchange where all individuals and small businesses will be required to buy their insurance policies beginning in January of 2014.

Vermont insurance companies will have to offer policies with identical benefit packages and various levels of deductibles and co-payments.

The federal Affordable Care Act also requires that two multi state insurance companies offer coverage in each state. These are companies that have a presence in at least 30 states.

Robin Lunge is the state's Health Care director. She's concerned because federal officials have initially ruled that these multi-state companies can offer a scaled back benefit package that meets federal standards but not necessarily all of the services that have been mandated in Vermont.

She says the out of state companies could charge lower premiums because they don't have to offer as many benefits as Vermont companies:

(Lunge) "I think it is a possibility because the feds can preempt state law but there's nothing that we as a state can do to impact that other than advocate with the feds that we think there should be uniform standards across the markets."

(Kinzel) Lunge says the federal plan covers ten essential benefits, including hospitalization, ambulatory care, emergency care, maternal and newborn services, chronic disease management and mental health treatment.  But she says some Vermont mandates are not included.

(Lunge) "In terms of whether for example the state mandate around chiropractic would have to be covered, that we don't know yet until the feds tell us whether they will require those plans to meet our mandates. That's certainly what we would hope."

(Kinzel) And Lunge says a comprehensive consumer education program will be needed if federal officials don't change their current approach.

(Lunge) "So the important thing would be that consumers know what they're getting when they buy those plans and that they know that they're getting a lower standard of coverage than what's required under Vermont law."

(Kinzel) Lunge says Vermont is joining with many other states to strongly encourage the Obama Administration not to adopt regulations that pre-empt individual state health care mandates.

For VPR News I'm Bob Kinzel in Montpelier.

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vermont_legislature vermont_health_department health_care public_health_care_bill
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