Vermont’s Health Care Debate Focuses On Federal Mandate

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(Host) The role of the federally mandated consumer exchange is emerging as one of the most controversial issues in this year’s health care debate at the Statehouse.

VPR’s Bob Kinzel report.

(Kinzel) The exchange is designed to be a consumer marketplace where individuals and businesses can shop for health insurance policies based on similar benefit packages.

Under the federal law, participation in the exchange is voluntary but it encourages individuals to buy policies this way by offering premium subsidies and it offers tax credits to small businesses.

The Shumlin Administration wants to drop the voluntary approach. Instead, it wants to mandate that all businesses with fewer than 50 employees buy their insurance on the exchange.

But that decision isn’t sitting well with some business groups. Betsy Bishop is the president of the Vermont Chamber of Commerce. She strongly supports the voluntary approach.

(Bishop) "It’s really how we implement the exchange in Vermont. It’s a core issue of making that exchange successful. We believe that the Exchange should be voluntary for all sized employers."

(Kinzel) Governor Peter Shumlin disagrees.

(Shumlin) "Let’s remember that the federal bill has some great benefits to it. You can’t get federal tax credits and subsidies unless you’re in the exchange. So the more people we can get in the exchange, the better federal subsidies to help Vermonters who are struggling to pay for their health insurance right now."

(Kinzel) Why would a business want to purchase a policy outside of the exchange and forego the federal tax credits?

Bishop says some employers might want the option of pursuing innovative cost-containment programs that might not be offered by insurance companies inside the exchange.

(Bishop) "I would say that if there’s a market outside of the exchange that the industry would lead in that innovation and continue to do that. There could be additional wellness initiatives there could be additional help for businesses. There could certainly be a plethora of other services that could be offered in addition to that health care plan."

(Kinzel) The Governor says he has another motive in making participation in the exchange mandatory for small businesses. He sees it as a bridge to a single payer system.

(Shumlin) "The Green Mountain Health Care Board is designing the first health care cost containment system in America that’s going to work and in order to do that it helps us to have as many people as possible in the exchange in the long run it will help us get everyone into a single pool."

(Kinzel) House leaders hope to have the health care bill on the floor for consideration in the next few weeks and it’s expected that the role of the exchange will be a major part of that debate.

For VPR News, I’m Bob Kinzel in Montpelier.

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