2006 Legislative Updates:

  February 8, 2006

House Health Care Committee: The committee marked up version 2.1 of the bill on Wednesday and expects to vote it out Thursday or Friday:

Policy: “It is the policy of the state of Vermont that all Vermonters
receive affordable and appropriate health care ....... First steps to achieving that goal are the prevention and management of chronic disease and coverage of the uninsured through the Catamount Health Plan, a self-insured, complete benefit plan with sliding-scale premiums.

Benefits Plan includes primary care, preventive and chronic care, and hospital services actuarially equivalent to the state employees’ SelectCare POS plan.

Uninsured means “an individual who does not qualify for Medicare, has no other insurance or employer coverage that includes both hospital and physician services within 12 months prior to the month of application, or lost insurance or employer coverage during the prior 12 months.”

Chronic Care infrastructure strategic plan to be established by executive committee.

Chronic Care management for those in Medicaid, Dr. Dynasaur, Catamount plan.

Waiver from CMS required for administration and financing of Catamount plan through Global Commitment.

Funding mechanism: Funding through the Global Commitment to leverage federal matching dollars. Estimate: state funds $78m plus federal funds $84m.

Monthly Premium estimates:family single

Under 200% FPL $60 $30
250% $100 $50
300% $150 $75
350% $235 $115
400% $400 $200
450% $855 $310

Over 450% can purchase at full premium cost.

Reinsurance: State would reinsure costs of the Catamount plan. State would pay 75% of all spending above $30,000.

Reimbursement at Medicare plus 10%.

Expansion: Monitoring mechanism to determine if/when the plan can be offered to additional populations. Under-insured would be the first target.

Vermont Health Care for All would like to thank VPIRG for their generous support of the 2006 Legislative Updates. They are also available on the VPIRG website http://www.vpirg.org. They will be produced throughout the 2006 Legislative session by Paul Forlenza. Forlenza can be contacted at paul@forlenza.us or 802-453-3592.