As states open insurance marketplaces amid uncertainty about whether they're a solution for health care, Vermont is eyeing a bigger goal, one that more fully embraces a government-funded model. Two years ago, the state passed a law to launch the nation's first universal health care system. Highlights of the plan:
WHAT'S IN PLACE
— Beginning in 2017, the state will offer a set package of coverage benefits to every Vermont resident under the program, called Green Mountain Care.
— A five-member board created under the law has already launched four pilot projects designed to bring down health care costs. For example, one bundles the price of services that often come together, as in a single, set price for the anesthesia, surgery and follow-up physical therapy connected with a knee replacement.
— The overall goal of the law is to "ensure universal access to and coverage for high-quality, medically necessary health services for all Vermonters." It aims to prevent costs and other barriers from keeping people from accessing health care.
—Launching Green Mountain Care will require a waiver from the U.S. government to use federal health care funds to run it. A division of the U.S. Department of Health and Human Services will decide whether to grant the waiver, likely late in the Obama administration's final term, said Robin Lunge, Gov. Peter Shumlin's director of health reform. She said Vermont had been successful in winning earlier waivers allowing it to make changes to its Medicaid system.
—Vermont lawmakers must also approve a state financing plan, which has yet to be developed. The Legislature signaled its support for some form of state financing when it passed the law in 2011.
—Eventually, the five-member board created by the law will have the authority to set payment rates for health professionals and approve hospital budgets. The goal is to get away from a financing system in which the more procedures are performed, the more doctors and hospitals get paid, to one similar to those used by schools, in which an annual budget is set for serving a certain population.
Source: AP reporting