Change is never easy and some change is less easy than others. As some Vermont businesses (those with fewer than 50 employees) begin to figure out how to enroll employees in Vermont Health Connect, there is a lot of head scratching going on.
It's not just that Vermont is switching from apples to oranges in terms of how people are insured, and it's not that only some Vermonters are going to be required to switch now while others are exempt for some unspecified amount of time.
And it's not just that employers are urged to continue to "sponsor" their employees for health care while residents of Vermont are encouraged to "enroll."
The whole system is difficult to comprehend and while it may ultimately work in lowering health care costs and ensuring that all Vermonters have health care coverage, the system has flaws in its execution and has flaws in its concept and has flaws in how it was adopted by the Legislature.
The idea is that businesses (with fewer than 50 employees) should continue to sponsor their employees' insurance. Sponsor translates into telling the health exchange that your company will pay $XXX per employee per month. Sponsored employees take their $XXX to the exchange and purchase the plan they want. If their $XXX is not enough, the balance comes from their paycheck.
Should an employer choose not to "sponsor" their employees and let their employees fend for themselves by selecting and paying for a plan from the exchange, the employer faces a financial penalty and the employee may or may not qualify for a reduced rate plan and tax credit – based on their income level.
Those who currently have no insurance or whose employer does not provide insurance to their particular category of employee can go to the exchange, find a plan and likely qualify for a reduced rate and tax credit – based on income level.
Where this great idea fails is in exempting such a significant number of Vermont employers and employees from the mandated exchange. All companies with more than 50 employees are exempt, including the 70,000 state of Vermont employees, college and university employees, school employees, etc.
Despite the lofty goals, getting in the exchange is painful, costly and confusing. It was and is wrong to exclude so many Vermonters from the exchange while mandating the smallest businesses into it – like canaries in the coal mine.
This difficult transition should have been born by all of us.