One out of every six Vermonters, about 100,000 people in a state of 630,000, must switch the way they enroll and buy for health insurance this fall with the opening of a federally mandated online marketplace called Vermont Health Connect.

It’s a massive change required by the 2010 Affordable Care Act that the Republican U.S. House of Representatives voted for the 37th time last week to repeal.

While state officials in Vermont have designed and are building this state’s new health insurance marketplace, also known as a health benefit exchange, it won’t be the much talked about single-payer system. That development, if it materializes, won’t happen until 2017.

In the meantime, Vermont Health Connect will offer private health insurance plans to its customers, most of whom have private insurance coverage now.

That’s why Blue Cross and Blue Shield of Vermont, the state’s biggest private health insurer, has undertaken a massive educational outreach campaign that included the opening Monday of a walk-in center where individuals and business owners can drop in without appointments to get answers to their health insurance questions.

“Today is about getting the word out,” Blue Cross CEO Don George said at the opening of his company’s new information center, a bright office full of cubicles that is located between Tropical Nails and Clay’s women’s apparel store at the Blue Mall on Dorset Street.

George noted in a written statement that he and other Blue Cross staff had already crisscrossed the state to host seminars on the upcoming transition to Vermont Health Connect.

“I have traveled throughout Vermont meeting with thousands of individuals and small business owners and they will need ongoing information and support with this important transition,” George said.

Under the federal health reform law, several categories of Vermonters must switch to using Vermont Health Connect for insurance purchases when enrollment opens Oct. 1. Those include:

• Individuals without insurance.
• People who have been covered by Catamount Health.
• Some people who are now covered under the Vermont Health Access Program.
• Small businesses with 50 or fewer workers, even small businesses that have purchased health coverage through associations.
• In 2016, businesses with 50-to-100 employees will need to buy insurance through Vermont Health Connect.

The exchange will offer federal tax credits and subsidies to many purchasers, depending on their incomes.

The federal law not only provides incentives, it includes penalties for individuals who don’t have health insurance: $95 or 1 percent of income, whichever is greater in 2014. By 2016, the penalty will grow to $625 or 2.5 percent of income.

The new information center in the state’s most populous county is just part of Blue Cross’ outreach. George said that 10 percent of the Berlin-based company’s staff has received special training on how the exchange will operate and what will be offered. Blue Cross has dedicated a toll-free telephone line — 1-800-255-4550 — for calls about the new exchange.

“The exchange team is ready and energized to see you through the entire process,” said Allison Plante, one of the newly trained staff.

Gov. Peter Shumlin stopped by the opening of the new exchange information center. He noted that Vermont could have let the federal government run the insurance marketplace for the state.

“We chose to set up our own exchange and do it the Vermont way,” Shumlin said. “We couldn’t do it without this partnership with Blue Cross.”

While George and Shumlin focused on the challenge of reaching all the Vermonters affected by the required move to Vermont Health Connect, Darcie Johnston, a critic of both the federal and state health care reform initiatives, said she worries that the ambitious reorganization of the insurance market will fail.

The state may be successful in setting up a website where people can enroll in insurance plans by next fall, she said, but she questioned whether the necessary links between the exchange and the Internal Revenue Service and state tax department would work to make it possible for Vermonters to get the promised tax credits.

“I don’t think it is going to work,” Johnston predicted. “Even if Vermont is ready, the Feds aren’t,” she suggested. “What happens if the federal government says we can’t do this for another year?”

Failure of the exchange system would recast the characterizations of this past week which many observers have painted one of the political toughest for President Obama. It would be a disastrous legacy, for Obama and for Shumlin, if this exchange system flops.

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April 21st, 2013