Vermont Set To Increase Medicaid Eligibility With Federal Money

07/11/12 7:34AM By Bob Kinzel
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The State of Vermont is set to receive several hundred million dollars in new Medicaid funds as part of the Affordable Care Act.

A key part of the Affordable Care Act calls on all states to expand their Medicaid eligibility standards to at least 133 percent of federal poverty levels. For a single person this would be roughly $14,500 and $30,000 for a family of four.

This provision will have little impact in Vermont because eligibility levels are already much higher. In most cases, a person is eligible for Medicaid with an income up to 300 percent of poverty levels.

But Vermont's Medicaid program will benefit from the Affordable Care Act because the state's congressional delegation worked to increase Vermont's overall Medicaid funding rate.

Senator Bernie Sanders says it wasn't fair to penalize the state for taking the lead on Medicaid eligibility.

"The issue here was that the goal of the health care reform was to expand Medicaid coverage especially in those states that were not providing much coverage," said Sanders. " And what we found is that Vermont in the initial writing of the bill was being discriminated against because we had fairly comprehensive coverage."

Mark Larson is the commissioner of the Vermont Department of Health Care Access. He says there are roughly 47,000 Vermonters who are uninsured or about 7 percent of the state's population.

Larson says this new money should help reduce this rate because half of all uninsured people in Vermont are eligible for Medicaid. He thinks the individual mandate of the Affordable Care Act will encourage many of the uninsured to sign up for these services.

"Enrolling that group of Vermonters who currently are eligible but not enrolled is one of the big goals of Vermont's efforts around the Affordable Care Act," Larson said, "providing better coverage to those Vermonters will improve their help as well as improve the financing of our whole health system."

And Larson says an expansion of the Medicaid program will be one way that the state can bring overall health care costs under control.

"We do know that individuals who have health coverage tend to be healthier," he said. "And so we think that the progress that can be made under the Affordable Care Act will be a big advantage to Vermonters."

Larson also expects that some people currently enrolled in Medicaid will shift to private coverage because they'll be eligible for federal subsidies in the state's new health care exchange starting in 2014.


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