Vermont had two choices when it came to implementing the federal Affordable Care Act: Go with the one-size-fits-all federal exchange or set up its own exchange using federal money.
Vermont chose the latter, and over the past few weeks there have been a number of voices saying that was the wrong decision. Everyone is entitled to an opinion, but there is one very important reason Vermont went with its own exchange: Not doing so would have cost hard-working Vermonters hundreds if not thousands of dollars in additional insurance expenses each year.
For decades, Vermont has been a leader in health care reform. That’s a good thing. It’s why we’re one of the healthiest states and have one of the lowest uninsured rates. State programs like Catamount and VHAP were making insurance more affordable for Vermonters years before anyone had even heard of Obamacare.
When the smoke cleared after years of fighting over the Affordable Care Act, it became clear that in some cases subsidies offered through state programs like Catamount and VHAP were more generous than what was to be available under the new federal law. That was a problem for Vermonters. All of a sudden we were faced with the very real prospect that the federal Affordable Care Act would actually make care less affordable for many middle-class Vermonters.
Vermont had a choice: Accept the subsidies available through the federal exchange and let insurance costs for many Vermonters increase, or set up our own state-based exchange and offer additional state subsidies to keep insurance costs from rising. There being no way to offer additional state subsidies through the federal exchange, the only option was to set up a state-based exchange.
That wasn’t a small decision for Vermonters. Had Vermont gone with the federal exchange, Vermonters would have seen an added $1.85 million in insurance costs in 2014 alone.
On the individual level that’s real money. A Vermonter making $34,000 per year would have seen additional insurance costs of more than $500 in 2014. A Vermont family with a combined income of $70,000 per year would have seen an additional expense of over $1,000 per year. It’s up to the critics of our decision to go with a state-based exchange to explain why imposing those additional insurance expenses on Vermonters would have been a prudent course of action.
The rollout of Obamacare was rocky throughout the country, and Vermont was not immune. It may be good politics for individuals to argue that Vermont should have gone with the federal exchange, but it would have been extremely bad policy that would have cost hard-working Vermonters lots of money.
Robin Lunge is Vermont director of health care reform.
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