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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Despite Pleas To Bypass Troubled Exchange, Shumlin Stays The Course

AP File/Toby Talbot
In this 2013 file photo, workers at the Vermont Health Connect call center talk to customers in Burlington.

Ongoing problems with the state’s health care exchange have prompted renewed calls for major changes in the way that individuals and small businesses purchase health insurance in Vermont. But Gov. Peter Shumlin is resisting these changes.

Vermont Health Connect has had technical problems right from the start. For instance, the online payment system for small businesses has never worked and there’s no solution on the horizon. So the Shumlin Administration is allowing these businesses to buy their policies directly from the insurance companies through next year.

There are also roughly 15,000 people who signed up for coverage and need to make some changes to their applications, such as a change in income or marital status, but the system won’t let them do it. And the number of people in this category is growing despite efforts to fix this problem.

Two House Republicans, Patti Komline of Dorset and Heidi Scheuermann of Stowe want the governor to follow the small business model and let individuals bypass the exchange and purchase their coverage straight from the insurance companies. Komline says this change needs to happen now.

"The private carriers don't currently have the capacity, it is my understanding, to have that integrated approach to benefits. That's why we're trying to get the exchange to work." - Gov. Peter Shumlin

“It’s a mess. And this is a way that we can take a big section of the population, move them to the insurance companies like we did with the small businesses, and let them go directly to the insurance companies,” said Komline.

But Shumlin says the change will help only those individuals who don’t qualify for a federal or state subsidy because these benefits are available only for policies offered on the exchange.

“The private carriers don’t currently have the capacity, it is my understanding, to have that integrated approach to benefits,”  Shumlin said. “That’s why we’re trying to get the exchange to work.”

And Shumlin argues that Komline’s plan doesn’t help the state deal with the exchange’s basic technical issues.

“It doesn’t help to solve the problem. So what we’ve got to do is solve the problem,” said Shumlin. “What’s that mean? It means getting the exchange to do what we expect it do to.”

Overshadowing this debate is the governor’s plan to have Vermont become the first state in the country to implement a single payer system in 2017. Komline says the technical problems at the exchange should alarm Vermonters about Shumlin’s proposal.

"If you're not affected by the problems of the exchange now you should be very concerned. Because they're coming for you on this in a couple of years." - Rep. Patti Komline, referencing single payer

“And to think we’re going to build a system where we can handle the entire population of the state -- if you’re not affected by the problems of the exchange now you should be very concerned,” Komline said. “Because they’re coming for you on this in a couple of years.”

Vermont is the only state in the country to mandate that all individuals and small businesses go through the exchange to buy their health coverage.

A number of Democratic leaders at the Statehouse say they’ll consider eliminating this mandate next winter if the exchange continues to have major problems.

Bob Kinzel has been covering the Vermont Statehouse since 1981 — longer than any continuously serving member of the Legislature. With his wealth of institutional knowledge, he answers your questions on our series, "Ask Bob."
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