Vermont readies rollout

MONTPELIER, Vt.—So far, implementation of Vermont's 2006 health care reform law—aimed at increasing the percentage of state residents with coverage to about 96% from 90%—is going fairly smoothly, state regulators say.

For example, the first policies under a new program, called Catamount Health, that will provide state-subsidized health coverage to low-income uninsured individuals are expected to be issued by the Oct. 1 deadline set by the law, according to Susan Besio, director of healthcare reform implementation in Montpelier.

"Everybody's working frantically. Oct. 1 doesn't seem that far away anymore. In terms of health insurance products and premium assistance programs, we're running along. We're definitely going to be up and running Oct. 1," Ms. Besio said.

Earlier this month, the state contracted with GMMB, a Washington-based marketing firm that specializes in publicizing state programs that provide coverage to the uninsured, to begin its outreach and education program, according to Ms. Besio.

A draft of eligibility rules governing employer-sponsored health plans that would be deemed "substantially similar" to Catamount Health, and therefore exempt from the $365 per employee annual assessment on employers not offering such coverage, has been completed. Regulators have decided that an employer-sponsored plan that has a $500 or lower deductible would qualify, Ms. Besio said. Catamount Health policies, by contrast, will have $250 deductibles. Catamount currently provides only individual coverage. A decision on whether to include families was deferred until next year, according to Ms. Besio.

The increase in cigarette tax that began July 1, 2006, to help fund the program so far has collected $6.6 million, Ms. Besio said.

Two of the state's three licensed health insurers that have agreed to participate in Catamount Health—Montpelier, Vt.-based Blue Cross Blue Shield of Vermont; and MVP Health Care Inc. of Williston, Vt.—have filed initial rates and forms, which are being revised because, as had been expected, "they came in a little too high," Ms. Besio said.

Catamount Health premiums are projected to range from $60 for individuals with incomes of 200% of the federal poverty level to $135 for individuals with household incomes between 275% and 300% of the poverty level.

Perhaps the only hangup has been with the federal government. The state is still in discussions with the Centers for Medicare and Medicaid Services to obtain a Medicaid waiver, Ms. Besio said, which was necessary for the state to implement a chronic care management program for Medicaid members.