Catamount health plan expansion sparks disagreements

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(Host) The state’s new Catamount health plan faces a potential multi-million dollar shortfall.

But lawmakers hope the deficit can be resolved, and that they can go ahead with plans to increase enrollment.

Other health care experts, though, say that’s a bad idea and this is not the time to expand the program.

VPR’s John Dillon reports:

(Dillon) The same day that lawmakers heard about a potential $10 million deficit in the new Catamount health plan, they also heard from their consultant on ways to get more people enrolled.

Ken Thorpe told the Health Care Commission that one way to get more people covered is to cut the waiting time for those without health insurance.

(Thorpe) “Right now you have to be uninsured for 12 months. An option obviously for making more people eligible is to reduce that to something that’s closer to what many states use for their CHIP programs, which is a six month waiting period.”

(Dillon) Catamount is supposed to launch in October, and by 2009 the state projects about 16,000 people will sign up. Vermont has about 60,000 residents without health coverage.

Lawmakers were discouraged this week to find out that the plan could face a $10 million deficit by 2010. The red ink is likely because the federal government has so far refused to allow Medicaid money to be used to cover those who make up to 300% of the poverty level. The state was counting on the money to help pay for about half the people in the program.

Middlebury Representative Steve Maier co-chairs the Health Care Commission. He says the Douglas Administration needs to come up with a plan to deal with the potential shortfall. He says Catamount is the first step to covering the uninsured, and that the deficit should not stop plans to expand.

(Maier) “And the work of the commission this summer and fall is to look at ways of expanding and growing the health care reform efforts. There are a variety of ideas that we already have on the table. Some of them involve additional funding, and some of them don’t. It may, in the end, affect some of the things we can do. But I think we remain committed to moving forward with additional steps toward health care reform.”

(Dillon) But Bea Grause, the president of the Vermont Association of Hospitals and Health systems, says the potential deficit is worrisome. And she says now may not be the time to expand coverage.

(Grause) “It’s primarily important to make sure that we provide health coverage to more Vermonters. But we have to do it in a way that is financially responsible. Because I think the last thing that anybody wants to do is provide a benefit and then have to take it away.”

(Dillon) Jeanne Keller is a health policy analyst in Burlington. She believes it would be irresponsible to expand Catamount if there isn’t enough money to fund the current program.

(Keller) “It’s just astonishing to me that they’re not only continuing forward with unfunded promises for the first round of Catamount but even having discussions about how to expand it, when they can’t fund the first round. And they can’t even fund Medicaid, the existing program.”

(Dillon) Keller says lawmakers should pause and re-evaluate whether to go ahead with Catamount. But the Douglas Administration says it’s committed to the plan. And Maier, the co-chair of the health care commission, says it makes no sense to cut the program.

For VPR News, I’m John Dillon in Montpelier.

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