Will Catamount make the cut?
Advocates say nixing the program would be costly
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Melanie Lebel of Rutland Town is one of the people insured by Catamount Health in Vermont. Albert J. Marro / Rutland Herald |
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By DANIEL BARLOW
Vermont Press Bureau - Published: January 4, 2009
MONTPELIER – A year ago lawmakers at the Statehouse wanted to expand Catamount Health, the state-sponsored insurance plan, but now many wonder if it will survive cuts to the state budget.
Lawmakers face the difficult task of balancing the budget as tax revenues plummet, and in the current economic climate legislative leaders have said "everything is on the table."
"I don't have a crystal ball," said Susan Besio, director of the Officer of Vermont Health Access, which oversees state insurance plans such as Catamount and Dr. Dynasaur. "I've learned to never try to predict what the Legislature might do and these are times when the state will be making hard decisions."
Rep. Steve Maier, D-Middlebury, is the chairman of the House Health Care Committee and one of the lawmakers who helped create Catamount. He said the program has a lot of support among lawmakers and any attempt to cancel it would meet strong resistance.
During this economic recession, programs like Catamount, which subsidizes the cost of insurance for some Vermonters, is needed more than ever, Maier said. Pushing people off the state program, he said, would only increase the number of uninsured patients in Vermont and would cost more in the long run. It would also be a major step backwards for a state known for its progressive health care initiatives.
"It just wouldn't make sense from a policy or economic standpoint," Maier said. "We would have more people showing up at the emergency rooms for care and that is when it is the most expensive."
Catamount by the numbers
Launched in fall 2007, Catamount Health was designed to decrease the number of uninsured Vermonters. Lawmakers envisioned that 96 percent of the state's residents would be insured by 2010.
In December, a study showed that Vermont has made gains in increasing health insurance access. The Vermont Department of Banking, Insurance, Securities and Health Care Administration found that only 7.6 percent of Vermonters do not have insurance, a drop from 9.8 percent in 2005.
But how has Catamount Health fared since it was launched just over a year ago? That depends on who you ask.
Besio said early estimates indicated the state could help insure 25,000 Vermonters under Catamount. But that number included bringing people under other health programs, such as Medicaid or the Vermont Health Access Plan.
The Catamount total was later downgraded to 19,000. As of November, 6,120 people have enrolled in a version of Catamount that subsidizes premiums on a sliding economic scale; 932 people are on the full-cost version of the plan.
"We launched the program in November 2007 and saw strong interest, which dropped off a bit after a few months," Besio said. "But we've seen enrollment actually remain pretty consistent since then."
Peter Sterling, the executive director of the Vermont Campaign for Health Care Security, contracts with the state to help promote Catamount. This work includes traveling across Vermont to tell eligible people about the program – including workers who have been recently laid off.
"Everyday I meet someone who can't afford health insurance," he said.
Sterling warned that Vermont could erase its health care reform successes if Catamount is dialed back or if its costs are increased to the thousands of people who have signed up in the last 13 months. The state should supply additional resources to the program, he said, and drop other barriers to stimulate more enrollment.
"If a person's premium was increased from $100 to $135, that could be a big, big difference to them," he said. "For some people, that would push the program into a place where they can't afford it."
Maier said the state has made some good progress in the last year, but when asked if he was satisfied with where the program is today, he pointed out the state still has a long way to go to reach its goal of 96 percent coverage by 2010.
"We still have thousands of Vermonters without health insurance," he said. "There is still work to do."
The faces of Catamount
Two years ago, Melanie Lebel, 29, of Rutland left her waitressing job behind to form her own small jewelry design and sales business, Designs by Melanie. As a self-employed entrepreneur, she quickly realized that she could not afford health insurance in the private market.
She qualified for subsidies from the state under Catamount and now pays $65 a month for a plan that would have cost her nearly $400 a month if she had bought an individual policy through a private insurer.
"There's no way that I would have been able to afford that," Lebel said, adding that having insurance allowed her to get a treatment for a medical problem that plagued her for several years. "That's double my car payment."
Catamount Health also came to the rescue of Joie Lehouillier of Johnson. Lehoiullier and her husband run a small farm, and she works part time, but neither had health coverage for themselves or their 18-month-old baby.
Their child is now on Dr. Dynasaur, the state insurance plan for children launched by former Gov. Howard Dean nearly two decades ago. Lehouillier and her husband are covered by Catamount Health at a price far lower than the $1,300 a month that it would have cost through the private insurance industry.
"If it wasn't for Catamount, we probably wouldn't have health insurance," said Lehouillier, who added that she was worried that a medical emergency would bankrupt her family. "I just don't know how we would afford it."
She said the paperwork may seem daunting, but staff charged with signing up Vermonters to insurance plans can help people navigate the options.
"It takes some work to sign up, but the state was incredibly helpful," she said. "They are more than willing to work with you."
Low-hanging fruit
Catamount Health is not officially on the chopping block – yet. But with tens of millions of dollars still to cut from the current budget – and the more-than-certain prospect of cuts to next year's budget – it could be seen as a low-hanging fruit for those who are less enthusiastic about the program.
Senate President Pro Tem Peter Shumlin, D-Windham, caused a minor stir last month when he suggested that the program was unsustainable without additional federal assistance – a sign that some took that the powerful senator did not support the program. (Shumlin later clarified his remarks, explaining that he was not suggesting that the state eliminate Catamount.)
But the program is costly. The state budgeted $19.2 million this year for Catamount and has spent about $7.6 million so far in this fiscal year, which ends on July 1, 2009.
Sterling said "anything is possible" in this economic climate, but he doubts the state would take the drastic step of nixing Catamount.
"The state doesn't want to throw thousands of people off the rolls and leave them without health insurance," he said. "That would be a disaster. I know there are some in the Legislature who weren't around when Catamount was formed, but most lawmakers get it."
Many are hopeful that President-elect Barack Obama's administration will help Vermont fund its health care programs.
Early next month Gov. James Douglas is scheduled to appear at a health care conference in Washington, D.C., where he will join California Gov. Arnold Schwarzenegger to discuss state health care programs, including Catamount.
"Catamount is very similar to the concepts of health insurance coverage that President-elect Obama spoke about while campaigning," Besio said. "We've also been a leader in using technology to improve service, which is a big part of his plan."
There is a lot the upcoming Obama administration could do for Catamount, Sterling said, starting with removing some barriers that the Bush administration has in place. This includes expanding premium subsidies beyond 200 percent of the federal poverty rate, which make the program more affordable for more people.
"As the state once said to the Bush administration, they either need to lead or get out of the way," Sterling said.
Health care reform is a major part of Obama's agenda and Maier said he expects to see a large federal investment in state health care programs in 2009 followed by a more comprehensive plan from the new presidential administration in 2010.
"Even just a small investment from the federal government could go a long way here," Maier said.
Contact Daniel Barlow at Daniel.Barlow@timesargus.com.
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