Catamount Health Participants Could See Reduction In Benefits

12/06/12 7:34AM By Bob Kinzel
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One of the biggest health care issues of the upcoming session will be Governor Peter Shumlin's plan to reduce the benefit package for some of the participants in the Catamount Health Care program at the beginning of 2014.

This has become an issue because the state's current subsidized health care programs; the Vermont Health Access Plan and Catamount Health, will be eliminated at the end of 2013. Roughly 30,000 low income participants will be enrolled in the Medicaid program and the remaining 17,000 people will purchase their coverage directly from Vermont's new Health Care Exchange.

The Medicaid group will see little change in coverage but people who enter the Exchange will face substantially higher out of pocket expenses because their benefit package won't be as  comprehensive as their existing coverage.

For instance, an individual making roughly $28,000 would see their out of pocket expenses rise from $1,800 to more than $5,000.

The Governor says he's looking for a solution but he says the state simply doesn't have the money to deal with this issue.

"We won't really know what it's going cost until we figure out what proposal we're going to come up with that helps to close the gap" said Shumlin.  "The entire cost if you were going to replace everything is upwards of $15 to 17, 18 million so obviously we don't have that kind of money around."

And Shumlin says the current benefit package is probably too comprehensive.

"There are parts of our existing program that are more generous than they need to be."

The outcome of this debate will directly affect Dan Dinolo of Lincoln. The 62 year old was laid off recently and now receives his health care from the state. He thinks it's counter productive to increase co-pays and deductibles on folks who are struggling to get by.

"I think there would be a lot of cases where you would defer to have something done or not do it at all and then you'd deal more in crisis management but bottom line if I need the care I'm going to go get it and then that's going to come out of savings or whatever."

This entire issue has caught the attention of House Health Care chairman Mike Fisher.

"I have believed for some time that we're going to have to find a way to minimize that exposure if we're really trying to reduce the number of Vermonters who are under-insured."

Fisher says part of the solution could be to transfer some of the state's existing health care subsides to a new program that would augment federal subsidies that will be available when the Exchange begins to operate in January of 2014.

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