Backers say risk pool plan cuts health insurance costs

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(Host) A new idea for health insurance is in the works in Brattleboro.

Backers of the plan say they can cut costs and promote better health by creating a community-based risk pool.

VPR’s Susan Keese reports:

(Keese) The plan was developed by a Brattleboro cardiologist and a business owner looking for a smarter way to insure his employees.

They decided that what made sense was a coalition of local employers and other groups in the area who need insurance. That would create the economic advantage of a good-sized risk pool.

Supporters say the fact that the plan is “Brattleboro-centric” would make it cheaper to administer from the start.

But Brattleboro cardiologist Mark Burke says longer-term savings would come from improved community health. Burke is a co-founder of the new plan. He says health care is essentially local.

(Burke) “And when your health plan is being run from Nebraska or something, they don’t know anything about Brattleboro. But our health plan is going to be in Brattleboro Vermont and it’s going to be run by people in Brattleboro Vermont and we’re going to be taking care of people in Brattleboro Vermont.”

(Keese) One important feature is a partnership with a new YMCA that’s being planned for Brattleboro’s north end.

The Y would help with health education and develop individualized wellness plans to help fight costly health risks, like obesity.

Burke says the current system almost encourages employers to switch insurers every few years to get a better deal, which means there’s little incentive to invest in long-term wellness programs whose savings may take years to realize.

But he says a community like Brattleboro is a different story.

(Burke) “The citizens live here. The corporations stay here. It’s not a transient population. And there are a lot of places like this across the country. S o it works here especially because the community is willing or should be willing to make that long term commitment.”

(Keese) The plan would also set up advisory councils that would involve health care providers, employers, citizens and the insurance company.

Several major local businesses have expressed interest depending on the final premium costs. Those depend on the outcome of a formal state review. John Crowley is the commissioner of the State Banking, Insurance, Securities and Health Care Administration. He says in order to sell health insurance policies in Vermont, the company will have to post a multi-million dollar bond. They’ll also need an actuarial analysis that shows they can pay their claims.

(Crowley) “We want to make very sure that a company that’s going to do business in Vermont is solvent. And I suppose you could call that a high bar but… I keep coming back to what your resources are.”

(Keese) Crowley says he hasn’t seen any applications for new health insurance companies in the three years he’s been in office.

For Vermont Public Radio, I’m Susan Keese.

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