Vermont exchange train wreck
On Sept. 12 the nationally known consulting group Gartner Inc. delivered a report to the federal Center for Medicare and Medicaid Services. The report assessed the operational readiness of the various state health insurance exchanges as the Obamacare-mandated launch date — Oct. 1 — approached.
Vermont Health Connect, the state’s $170 million exchange, is “one of the most functional in the country,” according to Gov. Peter Shumlin. That’s conceivably true, since most if not all of the other exchanges are in serious trouble, but the Gartner report concluded that Vermont Health Connect “should be considered in RED status due to significant risks to meeting the Oct. 1 deadline for Go-Live.”
The statutory deadline of Oct. 1 has long since gone by, but Vermont Health Connect remains essentially inoperative. You can review the Obamacare-approved insurance plans offered for 2014, but you can’t buy one. Kyle Midura of WCAX-TV observed on the Oct. 18 “Vermont This Week” program that site visitors “almost inevitably get an error message.”
Governor Shumlin first dismissed Vermont Health Connect’s missed opening date as a “nothing burger.” He then said the exchange would be operative by Nov. 1, and that unspecified people were “working 24/7” to get it going. Most recently, he waffled on the Nov. 1 deadline as well, saying it might be ready by Nov. 3. Midura noted that administration officials view this as a “soft deadline” — more a suggestion than a requirement that triggers real-world consequences.
But for many tens of thousands of Vermonters there are real-world consequences to not being able to buy health insurance on Vermont Health Connect. Thanks to a unique monopoly feature of Vermont’s Act 171 (2012), Vermonters who are thwarted by an inoperative exchange site cannot choose to continue their present coverage with their present insurer. This monopoly feature, in force in no other state, applies to currently insured individual purchasers and small business groups of up to 50 employees.
The reason for the monopoly is that Governor Shumlin and his single-payer allies are trying everything possible to lure or force people into the exchange before 2017. On that date state-run, taxpayer-financed Green Mountain Care is supposed to replace all health insurance.
This $3 billion-plus single-payer plan will be financed in large measure with a federal block grant equal to the sum of all the Obamacare tax credits paid on behalf of the people buying through Vermont Health Connect. (GMC will also require an enormous payroll tax increase, as the governor has recently admitted.) Forcing the insured into the exchange will maximize that hoped-for (but by no means assured) federal payment.
Fortunately, the 2012 law contains an emergency clause.
On Oct. 22 the Ethan Allen Institute sent a letter to all legislators. It described the situation and concluded: “If these problems are not worked out well before Dec. 31, it seems unavoidable that thousands of Vermonters will wake up on New Year’s Day to find themselves and their families without health insurance coverage — unable to buy what they are required to buy, and with no legal alternative to turn to. But there is a solution.
“The 2012 Legislature … inserted Sec. 41a into Act 171. This section authorizes the commissioner of financial regulation to ‘allow for the extension of a small group and association plan beyond their renewal date in order to ensure a smooth and orderly transition from health plans offered in the small group and association markets in 2013 to health plans offered in the small group market through the Vermont health benefit exchange in 2014.’”
The Ethan Allen Institute letter asked legislators to use an enclosed post card to show their support for the commissioner of financial regulation to invoke this emergency clause “no later than Nov. 18, if by that date Vermont Health Connect is not fully functional.” So far the commissioner has made no public comment on the issue.
In an incisive and scathing article on The Daily Beast (Oct. 22), former Vermont resident Stuart Stevens foresees a “unique train wreck” developing in Vermont, due to a failed exchange designed as an essential gateway to the single-payer system.
Stevens concludes: “As this great health insurance experiment proceeds, Vermont bears watching. If this small, healthy state can’t make Obamacare work to a high degree of satisfaction, it doesn’t bode well for more difficult challenges.”
He might have added, “It certainly won’t bode well for Vermonters.”
John McClaughry is vice president of the Ethan Allen Institute (www.ethanallen.org).