The Affordable Care Act calls on states to establish their own exchanges over the next 18 months, and if a state fails to take this action, the federal government will come in and set one up.
The idea is to create a marketplace approach to health care policies and allow consumers to compare the cost of various insurance plans that have similar deductibles and co payments.
Robin Lunge is the state’s Director of Health Care Reform. She says Vermont has made great progress in meeting the federal requirements to set up a state exchange.
"The feds were very positive about where Vermont is. We are definitely leading the nation in terms of our planning and policy development…so we’re in good shape."
Lunge says the state is now eligible to apply for a second federal grant to fully implement the Vermont exchange. Although the details of the grant are still being worked out, she says it should provide the state with at least an additional $20 million.
"We received a Level One grant last year for $18 million, now we’re applying for what the feds are calling the Level Two grant and this is the grant that will take us through 2014 and establishing the Exchange."
Currently, Vermont has several different programs to help subsidize premiums for low and middle income people. Lunge says one of the major projects of the second grant will be to consolidate them into one comprehensive program.
"What we’re looking to do is to create a system with the Exchange so that we don’t have the situation we have today with 4 or 5 different programs where people don’t really know what they’re eligible for, what kind of help they might be able to get and where they might be able to get health coverage," said Lunge. "We want to make it straight forward and simple so that there’s a one stop shopping if you will through a centralized place where anyone can get coverage."
In the next two weeks, the U.S. Supreme Court is expected to rule on constitutionality of the Affordable Care Act. Lunge says Vermont’s strong health care consumer protection laws will remain in place even if the Court strikes down key parts of the law.
"The most likely scenario is that the Court would strike down some of the insurance provisions in the Act and let the rest of the law stand and for Vermont that will not be a game changer," Lunge says. "We have already adopted a number of rules that the feds adopted in the Affordable care Act…so Vermont law still stands."
Lunge says the decision could have a major impact on Vermont’s plan to move towards a single payer system if the Court throws out the federal subsidies that are designed to make coverage more affordable for individuals and small businesses.