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Vermont's two providers of health care through Vermont Health Connect filed their proposed rates for 2015 with the Green Mountain Care Board this week and guess what?
Rates are going up.
No surprise, really. Vermont's health care exchange has been a complete disaster since its rollout and much of the work that should have been handled by the state got dumped on the two insurers who are designated to insure the entire state.
That should really be no excuse for an almost double-digit increase from Blue Cross Blue Shield (9.8 percent) and a double-digit increase from MVP (15.4 percent). As for reasons for the steep increases, both carriers cited federally mandated changes as well as changes in state and federal health care reforms which include increased federal fees (included in the exchange pricing), reduced federal subsidies for Vermont's exchange and a small expansion of dental benefits for children.
Blue Cross is the state's largest insurer, covering more than 220,000 Vermonters but only 57,000 through the state's health care exchange.
Blue Cross reports that its internal increases amount to 3.3 percent and that the federal and state changes create the additional 6.5 percent increase. That state and federal changes would cause such steep increases to the insurers selling on the exchange is an unfortunate contradiction. Weren't government-run exchanges supposed to mitigate steep increases?
What is probably most unfortunate about this is that it affects Vermont's small businesses that are mandated into the exchange but still doesn't impact employers with more than 50 employees and certainly does not impact state employees or the state's teachers or other unionized employees.
No one but the small business owners who are trying to continue to provide health care for their employees and individuals who are purchasing directly from the exchange will feel this pain.
Can we expect that those individuals will receive a wage increase sufficient enough to allow them to pay 9.8 percent more for health care? Can we assume that employers can afford another 9.8 percent for their employees' health care without reducing other benefits or wages or cost of living increases?
Remember that only some 90,000 Vermonters are insured through the health care exchanges, tens of thousands of whom got shifted in from Medicaid, VHAP or Catamount. That leaves precious few souls to be paying these increases while the bulk of Vermont employees continue with their own private coverage.
The flaws in Vermont's health care exchange are legion, not the least of which is that so many, many thousands of people and employers who should have skin in the game simply don't and that puts the burden squarely on the wallets of too few.