A ruling by the U.S. Supreme Court Thursday has reignited a debate over the future of health care reform in Vermont, and some critics of the state’s troubled health insurance exchange say the court decision should be a nail in the coffin of Vermont Health Connect.
The case is known as King vs. Burwell, and it’s been the subject of considerable speculation in Vermont. At issue is whether or not residents in states with federally administered health insurance exchanges are eligible for the subsidies that are part of Obamacare.
Lt. Gov. Phil Scott is among the Republicans who have been calling on Gov. Peter Shumlin to abandon a state-based exchange that has been beset with problems since its launch in 2013.
“The response has always been, well if we do that, if we go to the federal exchange, or we go to an alternative, Vermonters will … potentially lose their subsidies. And that’s not something that any of us wanted to see,” Scott says.
In a 6-3 decision released on Thursday, however, the Supreme Court erased those fears, ruling that the subsidies will flow to eligible recipients regardless of how states chose to set up their exchanges.
Scott says it’s now time to plot an exit from Vermont Health Connect.
“Because I think Plan A failed. We’re on Plan B now. And I think we need to look at Plan C,” Scott says.
Lawrence Miller, chief of health care reform for the Shumlin administration, says it’s premature to pull the plug on an exchange infrastructure that has already cost more than $125 million to build.
"Because I think Plan A failed. We're on Plan B now. And I think we need to look at Plan C." - Lt. Gov. Phil Scott
Miller says the option of moving to the federal exchange will become part of the administration’s contingency planning. But he says new change-of-circumstance software is on the verge or resolving the customer-service backlogs that have plagued the site since its launch. And he says the state is on track to have a well-functioning exchange by this fall.
“We’re on track with the milestones, and continuing to meet our objectives, so we’re focused primarily on completing that work,” Miller says.
House Speaker Shap Smith has authorized the House Committee on Health Care to hold meetings over the summer and fall, to monitor the administration’s progress on the exchange. Smith says he’s hopeful that the administration will be able to solve the problems on the exchange. But he says the decision in King vs. Burwell has expanded the universe of opportunities available to lawmakers if it can’t.
“For us, what it does is it gives us options if we are not able to make our state exchange work, and work in a financially sustainable way,” Smith says.
"For us, what it does is it gives us options if we are not able to make our state exchange work, and work in a financially sustainable way." - House Speaker Shap Smith
Miller says moving to the federal exchange would bring with it a whole host of new problems and added costs.
Vermont Health Connect is supposed to serve as the technological backbone for a new IT system at the Agency of Human Services. Abandoning it now, according to Miller, would ruin those plans, and possibly force the state to find outside contractors to administer state programs that would otherwise have been handled in-house.
Miller also says the federal exchange wouldn’t be able to distribute the state-based subsidies that Vermont offers to lower-income customers on Vermont Health Connect. Stowe Rep. Heidi Scheuermann says that problem ought to be easy enough to solve.
"I feel that we have wasted enough time and enough money on Vermont Health Connect, and now that we have this decision ... let's move." - Stowe Rep. Heidi Scheuermann
“It’s not rocket science,” Scheuermann says. “I feel that we have wasted enough time and enough money on Vermont Health Connect, and now that we have this decision ... let’s move. We’ve got to get this under control, and we’ve got to show some leadership.”
Smith is meeting to administration officials next week for a briefing on progress at the exchange.
