Vermont inches closer to tax-funded insurance for residents
Vermont could become the first state to provide and pay for insurance for most of its residents as soon as 2017 under a plan passed by the state legislature Thursday. But first, it must overcome several major obstacles, including persuading the federal government to allow the state to assume responsibility for Medicare and Medicaid enrollees and finding a way to fund the program, reports the Boston Globe.
Vermont's plan moves most people with private and government insurance into a unified system, called Green Mountain Care, in which their insurance would be paid for through their taxes, not through premiums and copayments.
At this early stage, however, there are many more questions than firm answers, according to the Manchester Journal. The new law is basically just a roadmap for now, and it won't be until 2014 or 2017 that "the rubber will meet the road," Rep. Jeff Wilson said. "What we have is a planning document that articulates goals, principles, and conditions for implementation--that process is fairly logical."
To flesh out the details, the bill sets up a five-member board which, in consultation with the executive branch and legislature, is to determine how the system will be paid for, what benefits will be covered, and what copays and deductibles it would include, ABC News reports.
The board also will design and administer new cost-control measures, including "global budgeting" for hospitals and other healthcare providers. Instead of the traditional "fee-for-service" system, Vermont's new system will be designed to pay for providing necessary healthcare to a given population.
Despite the bill's progress, there are remaining doubts whether it will move Vermont toward a genuine single-payer system. It leaves room for people to buy supplemental insurance and it's unclear whether the state's major employers, whose self-insurance systems are regulated under federal law, will be allowed to be absorbed into Vermont's system, notes ABC News.
Gov. Peter Shumlin is expected to sign the bill this month.
To learn more:
- read the ABC News story
- see the Boston Globe article
- check out the Manchester Journal piece
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