Vermont’s Reduction in Uninsured May Help Governor’s Reform Plan

The 2014 Vermont Household Health Insurance Survey indicates a significant drop in the number of uninsured Vermonters, which is welcomed news for Governor Peter Shumlin, who has been struggling to garner favor for his “Green Mountain Care” plan. The health plan seeks to change Vermont’s payment system from a premium-based model to one that is based on individuals’ ability to pay. The plan would be publically financed. Shumlin plans to outline his cost-focused, health care reform agenda in his annual budget address on January 15, 2015.

The Survey

Conducted between August and December 2014, the phone survey shows that the lowered number of uninsured Vermonters is a direct result of the expansion of Medicaid eligibility and some insurance coverage changes included in the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148). The governor noted, “With all the pains and struggle, it is clear that Medicaid expansion and the Affordable Care Act are benefiting Vermonters.” The last survey was taken in 2012.

2014 survey results reveal that approximately 19,000 of 43,000 Vermonters who had no health insurance in 2012 are now covered. This figure reflects a drop in the state’s uninsured rate from nearly 7 percent to 3.7 percent, which is the second lowest in America. Only 1 percent of Vermont’s children under age 18 are uninsured, which is also the lowest rate in the United States.

According to the survey, 310,000 Vermonters are privately insured, and 133,000 are now on Medicaid, with children under age 17 representing over 44 percent of that number.

The decrease in the uninsured rate spans across all income and age groups as well as geographic and demographic categories, although the survey reported that more men (almost 5 percent) are uninsured than women (2.5 percent). Nevertheless, both percentages show almost a 50 percent decline in the uninsured rate since 2012.

Every county in Vermont also experienced a reduction in the number of uninsured individuals. For instance, Essex County saw the largest drop from about 20 percent in 2012 to 10 percent in 2014.

For those who will remain without insurance, over 65 percent of uninsured Vermonters said the high cost of insurance is either the sole or main reason they do not have insurance coverage.

Budget Address

The cost of care is still a significant barrier in keeping Vermonters from obtaining insurance, the governor said. In his budget address, Shumlin will call for cost reforms such as:

  • health care payment structures that will shift to payments based upon quality rather than quantity;
  • a strengthened primary care system as part of Blueprint for Health, which has been proven to lower the cost curve while ensuring quality health care to Vermonters;
  • control over the cost shift that forces private insurance rates to cover inadequate reimbursements received for Medicaid care as Medicaid participation increases; and
  • the Green Mountain Care Board’s enhanced role in reducing health care costs with the long-term goal of lowering health care spending increases between 3 and 4 percent.

Perhaps the positive survey results will enable the enactment of the long-awaited Green Mountain Care plan.