By Jim Leddy, AARP Vermont State President
April, 2008
It was just about two years ago that my fellow lawmakers and myself sat night after night in the Statehouse and hashed out the details of a bill that launched the nation’s most comprehensive health reform initiative to date. It was a historic step and one that put our state squarely in the spotlight of a raging national debate on the health care crisis.
Making laws isn’t always pretty. While there were many items and provisions we didn’t always agree on in the process of crafting this legislation, there was one thing we all understood and accepted: this was just a first step and improvements would surely be needed. Two years ago I was very proud of what we had accomplished. Today I hope we will follow though on our promise to do it right.
Catamount Health was designed to cover uninsured Vermonters and the Vermont Blueprint for Health aims to address how we manage chronic health issues -- ultimately limiting the spiraling cost of our health care system in Vermont. Like a lot of legislation, Catamount Health was born of compromise – in this case between the need to provide affordable coverage to Vermonters and a desire to preserve the private insurance market. The Governor did not want a state-run plan, hence the public/private solution emerged with the state subsidizing premiums on a plan offered through private insurance companies already operating in Vermont. That is part of the problem we are facing today as we work to make needed fixes to the program – private insurers running a state program.
Now that we have successfully enrolled a few thousand Vermonters into Catamount, it’s clear that we need to make refinements. Some are glaringly obvious. Refusing coverage for pre-existing conditions is one of those. If our purpose with Catamount is to make health care affordable, how can we stand by when eligible Vermonters are being turned away or forced to pay themselves for a year because they may have been diagnosed with an illness or chronic condition. This provision is a function of the private insurance nature of this plan. State Medicaid programs such as VHAP and Dr. Dinosaur have no such impediments to care. Clearly, if our goal is getting health care to those who need it, this pre-existing condition clause must go away.
Another concern is the thousands of Vermonters who are underinsured. These folks have very high deductible plans that offer no coverage until one has spent $5,000 to $10,000 out of their own pocket. By most measures there are more than 50,000 Vermont citizens in this boat. With gas going well over $3.00 a gallon, heating and food costs up and wages stagnant, these plans add yet another staggering burden to the family budget. Further, every study confirms what most people already know -- high deductibles keep people from seeing their doctors except in emergency situations. That’s not really health care – it’s just catastrophic coverage. Catamount today requires one to go without any coverage at all for 12 months before becoming eligible. It effectively penalizes Vermonters who are already struggling to pay a premium they can afford. That needs to change.
A bill addressing changes to Catamount Health has passed the Vermont House and is now in the Senate for consideration. I call on my former colleagues in the Senate to look closely at these improvements as well as allowing children up to age 26 to remain covered under their parents plan. Those under 30 make up the largest segment of uninsured Vermonters and this small change would impact some 16,000 young Vermonters between 18 and 26 with minimal impact on plan costs.
Surely, these changes come at a cost and the budget is tight as always. But if we are to make this landmark health care reform package work for the citizens of Vermont as it is intended, these are costs we need to bear. Let’s make good on our promise of affordable health care and follow through on the plan adjustments necessary to reach that goal.
Jim Leddy is volunteer state president of AARP Vermont and a former state senator from Chittenden County.
