Ask me anything about the Vermont Health Care legislation.

[cali]

I just spent quite a bit of time with Annie Galloway-Kane who heads up vtdigger and who knows as much about about the legislation as anyone in the state. She's done extensive research and interviewing- everyone from Speaker Smith to the guv, to Hsiao, Steve Kimbell (who heads the Banking, Insurance and Health Care Administration.

I don't know even a fraction as much as Annie, but I think I can pass on some of her answers to my queries.

[bluerum]

1. Who is eligible? What role will existing health ins. companies be expected

to take? When does it go national ;)

[cali]

2. vermont residents are eligible.

Initially, because of federal requirements there will be an exchange set up. eventually, all health insurance companies will be phased out. There will be no insurance to buy. Vermonters will all get a state health care card that they will present at point of care.

[Hannah Bell]

20. what's the residency requirement? if i move there tomorrow am i immediately eligible?

what if i move there indigent & needing some expensive treatment? or non-indigent & needing it, for that matter?

[cali]

22. I don't think any of that has been worked out

due to Federal law, this is all pretty far down the road. What they're working on now is to bring costs down by capping the hell out of how much hospitals can raise expenditures in a year. Vermont Health Care is dominated by Fletcher Allen which is not only a large hospital but has been buying out practice after practice. Every year, over the last few years, FA's expenditures have risen by hundreds of millions. In addition, both hospital rate increases and insurance rate increases are now being capped.

I do know that the legislature did vote down an amendment which would have prohibited undocumented worker residents from being part of the system.

I'll ask Annie about indigent care.

[NotThisTime]

3. What if a Vermont resident has to seek treatment outside the State or Country?

Is this insurance going to be acceptable?

[cali]

12. outside of the state, yes. don't know about out of the country

[sufrommich]

4. How is it being paid for? nt

[cali]

13. that has not been decided. Here's what's being discussed:

tax on investments, such as NH has, junk food tax, payroll tax. Also savings. Vermont is capping (under legislation passed previously, how much hospitals can increase expenditures per annum at 4%)'
There are other planned savings as well, including such things as coding all procedures with the same code instead of many.

[sufrommich]

32. I'm excited for Vermont. If it's successful, I see other states

moving in the same direction. Canada's health care program started in Saskatchewan and moved across the country.Hopefully it happens here too.

[Name removed]

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[Name removed]

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[WonderGrunion]

7. Under what structure would Vermont have been able to implement

this law without the frameworks set in place by President Obama's Affordable Care Act?

[cali]

14. Sorry, I don't know.

[Chisox08]

8. How soon can I move to Vermont?

[cali]

15. come on up, or over or whatever direction you're coming from.

[mmonk]

9. What does it say in the third line?

Just kidding, thanks very much for this thread. I look forward to the questions and answers.

[mmonk]

10. What restrictions will the private insurance be under?

Besides all the different money in the system already that will be used, what other funding mechanisms will be there, especially in regards to the self employed?

[cali]

16. the plan is to eventually phase out all private insurance

though a third party may be contracted to be the provider service agent. For instance, (and it's not an insurance co, HP serves in that function for Medicaid in VT)

[mmonk]

27. To collect and disburse? Then they will receive the government

funds as well?

[cali]

28. again, this is all to be worked out.

[wiggs]

11. Do people still have the option of buying private insurance? Regardless of answer,

does this mean private insurance will be pulling up stakes and leaving or does it mean that private insurance will become much cheaper?

What do doctors in Vermont think about it?

[cali]

17. Doctors in Vermont are divided over the plan, with, as I understand it, most

non-specialists supporting it and fewer specialists doing so. Yes, the plan is to eventually phase out private insurers, of which only 3 currently operate in the state: MVP, BC/BS of Vermont (one of the few still operating as a non-profit and not owned by Anthem) and Cigna. In addition, some companies like IBM, self-insure.

[cali]

18. kick

[Vinca]

19. As a person nearing Medicare age (who lives right across the border and would consider a move),

does the legislation include a provision to cover what Medicare doesn't for seniors?

[cali]

24. I don't know, but I'll ask

[Vinca]

31. Thanks.

We love our house and the spot we live in across the river in NH, but we have to consider where we will be able to exist in our old age without going into medical bankruptcy.

[Capitalocracy]

21. What are they doing to reduce the ridiculous cost of care?

Are they offering government infrastructure for providing health care or just paying out a private system at any rate private providers see fit to charge... or somewhere inbetween?

[cali]

23. Great question. That's the main focus of what's happening now

please see my answer upthread. In 2010 Act 128 was passed giving The Banking, Insurance and Health Care Commission (now under Steve Kimbell, who's a tough son of a bitch) broad authority over hospital expenditure increases, rate increases and insurance premium increases. The private system will be in place until 2014 at the earliest and even though the plan is to ultimately shed all private insurance, under Federal law, VT has to comply with the exchanges.

[Capitalocracy]

25. But what I mean isn't the private insurance system, I mean actual care

like how much it costs to see a doctor, how much it costs to go to the emergency room, why you have to pay $50 for a $1 gauze bandage at a hospital, that sort of thing. Are there plans to do anything about that?

[cali]

26. yes, that's reallly part of what 128 does- by capping both expenditures

and rate increases.

[retread]

29. Will prescription drugs be included? Any attempt to lower drug costs? n/t

[cali]

30. Yes, prescription drugs will be covered. Sorry, I don't know if or how

they'll lower drug costs.