The Vermont Exchange is Coming

Vermonters for Health Care Freedom

With less than 100 days to go before the Vermont Exchange (Health Connect) takes effect for over 110,000 Vermonters, Vermonters for Health Care Freedom will be publishing a series of weekly newsletters and commentaries between now and September 15, 2013.

Vermonters for Health Care Freedom strongly opposes Vermont’s requirement that individuals and small businesses (<50) purchase health insurance only through the Exchange. On June 28, 2013, the US House Committee on Oversight and Government Reform Chairman, Darryl Issa, sent a 3 page letter to Mark Larson, Vermont Health Access Commissioner. The letter stated that Vermont’s Exchange was out of compliance with federal health care legislation (PPACA). Quoting from the statute:

“Nothing in this title shall be construed to prohibit-

(A) a health insurance issuer from offering outside the Exchange a health plan to a qualified individual or a qualified employer, and

(B) a qualified individual from enrolling in, or a qualified employer from selecting for its employees a health plan offered outside of an Exchange”

The language could not be clearer.

On July 2, 2013, Vermonters for Health Care Freedom issued a press release calling upon Governor Shumlin to bring the Vermont Exchange into compliance with Federal law, by allowing insurance to be purchased outside the Exchange.

However, while this is all playing out, we realize that the clock is ticking for the October 1 Exchange open enrollment period. Accordingly, we want to keep you informed about the ever-changing world of ObamaCare, which, at this point, is changing almost daily, and whether those changes are relevant to individuals and small businesses.

Vermonters for Health Care Freedom will provide information to help client businesses and newsletter recipients to help you wade through the morass of confusing choices, considerations and regulations brought on by the Vermont Exchange, “Health Connect.” We will keep you updated on requirements, timetables, and available resources.

If you are an insurance broker and wish to be included in our list of brokers, email your information to: Darcie@johnstonconsult.net.

Topics

This issue will generally address and clarify some overall issues related to ObamaCare and the Exchange.

How is an Exchange Supposed to Work? In brief, ObamaCare requires that each state set up an insurance Exchange where residents can shop for health insurance coverage. The intent is to greatly simplify health insurance shopping – a la Travelocity, for example, and to provide a broad choice of insurers and plans to choose from. The exchange rules require insurers to use common formats for health plan descriptions and premium rates, thus enabling shoppers to compare policies and benefits on an apples-to-apples basis, rather than the heretofore convoluted policy language.

The federal law requires that state exchanges be operational by January 1, 2014.

ObamaCare vs. ShumlinCare: Rather than set up a free market system as described above, Shumlin is using the Exchange and all the Federal dollars that come with it, as a transitional program which is designed to morph into his “single payer” dream. Instead of individuals and small businesses being able to use the marketplace freely, or to buy insurance outside the Exchange if they didn’t like the Exchange plans, these entities are now forced to buy only through the Exchange beginning in 2014. In addition, insurers are forbidden to offer insurance outside the Exchange to these people. The definition of small group is set to expand to businesses with up to 100 employees in 2016.

This provocative effort by the Administration is designed to force-feed bodies into Shumlin’s “single payer” model beginning in 2017. The federal law never intended to restrict choice or force people into the Exchange; in fact, quite the opposite. Vermont’s Exchange is a warped version of what ObamaCare actually calls for.

Why is the Exchange not “Single Payer?” Understandably there is massive confusion among Vermonters about what these two terms mean. The terms have been bandied about to the point where some actually think that the Exchange is “single payer”. The appropriate way to look at Shumlin’s Exchange (not the Exchange the federal law calls for), is as a precursor to “single payer” (i.e., the body feeder).

Shumlin and his Administration have come up with two phases of forcing Vermonters into a government-run health care plan. First, forcing individuals and groups of <100 employees into the Exchange by 2016, provides the fodder needed to fuel the “single payer” plan. If Exchange participation was voluntary as it is supposed to be, there would be far fewer people and groups in it. Remember, the Exchange is supposed to be a marketplace for Vermonters, not a health care prison.

Next, by 2017, presumably the “single payer” plan will be ready, so that many more Vermonters can be forced into a governmental health insurance plan. It should be noted that the term “single payer” is a misnomer. People covered by Medicare, or by an employer located in another state, or by an ERISA plan (a large employer self-funded plan exempted from such state health care laws), are still covered by their basic insurance plans. In addition, ShumlinCare is not a health care plan; it is still a health insurance plan, with the state paying your claims. Good luck with that.

Next week, in our August 1st newsletter, Vermonters for Health Care Freedom will discuss the Vermont Exchange, Vermont Health Connect, including how it works, premium costs and subsidies, how subsidies are determined, and online subsidy calculators. And we will update you on recent changes in ObamaCare, which are still ongoing.

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