• Forward and backward on health care
    February 01,2013

    On Jan. 24, Gov. Peter Shumlin presented his budget for the state of Vermont. Included in his proposals was funding to help Vermonters with some of the cost-sharing requirements under the soon-to-be health care exchange.

    Charts comparing the initial cost-sharing requirements (premiums, copays and deductibles) as put forward by the Green Mountain Care Board and Shumlinís proposals show clearly that the governor has narrowed the gap. However, itís not enough. While we may be moving forward for some with the expansion of Medicaid, we canít move backward for others.

    If Vermonters currently on VHAP or Catamount ó programs that will end with the opening of the exchange ó are faced with large increases in cost-sharing requirements, they will likely drop insurance and again have only free clinics and hospital emergency rooms to turn to for health care. Similarly, if people new to the exchange find these costs too daunting, they will choose to pay the relatively nominal penalty and become uninsured.

    At the Peopleís Health & Wellness Clinic in Barre, one of Vermontís 10 free clinic programs, weíve been assisting people with application and enrollment in Vermontís health insurance programs for years. Our lengthy experience has shown that no matter how good a job we do, some people are still getting their eligibility and premium notices and saying they simply canít afford the current rates. Or, they dig deep and make a monthís payment or two, but then canít stick with it.

    These folks also wonít be able to get back into the exchange under the new open enrollment period restrictions until the following year, even if they were able to find a way to pay. This is another change from the current system, which allows us to enroll patients in the stateís insurance programs year-round.

    We are proud to deliver quality care to our patients, but we see ourselves as only a temporary medical home. Getting our patients on insurance is better for them, their families and their employers, making them more productive at home and at work. Itís also better for the health care system, helping avoid cost shifting, and inappropriate and costly use of hospital emergency rooms.

    Iím glad the governor has bitten off a piece of the pie; it makes it a little easier for the Legislature to do the rest. However, if the canyon is 60 feet wide, and the governor shrinks it to only 30 but the patient can only jump 10, it doesnít make any difference.

    Peter Youngbaer is the director of the Peopleís Health & Wellness Clinic in Barre.

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