Health care reform obligations nearing

Local navigators offer assistance

Ian Lord

By Ian Lord

Staff Writer

Just
The Facts

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Yes, you’re going to have to sign up.

 

- David Southwick, chamber director

ST. ALBANS — Whether people like it or not, health care reform is coming and local organizations are trying to get a handle on the many questions that come with the change.

Wednesday night at City Hall in St. Albans, new FCCC Executive Director David Southwick answered questions from about 25 people who wondered how individuals, families and small businesses will navigate the changes.

Southwick and Lisamarie Charlesworth, executive assistant to the director at FCCC, have been trained as “navigators,” and are thereby qualified to assist those exploring the Vermont Health Connect exchange.

As one of the first states to adopt an exchange, Southwick said Vermont is in a unique situation, in that there is no real model to follow. While recognizing people’s concerns about the unknown, he said the chamber “won’t be able to change any policies.” The requirement for all Vermonters to be covered through Vermont Health Connect is set in stone, Southwick said.

“Yes, you’re going to have to sign up,” he said. “Everybody will be required to buy insurance through the exchange.”

The only alternative to doing so is to pay a penalty already provided within the federal law.

Southwick explained that with Blue Cross Blue Shield and MVP Health Care as the two Vermont providers, there are multiple levels of insurance, some with higher premiums, but with lower out-of-pocket expenses, and some with lower premiums, but higher co-pays and prescription costs.

Small businesses with fewer than 50 employees have the option to provide insurance through the exchange. Businesses can either offer specific coverage plans, or allow their employees to choose which type of coverage works best for them.

While the initial plans seem alarmingly costly for individuals and families, Southwick assured people that there are options for taxpayer subsidies to help pay for coverage. People making up to 400 percent of the federal poverty level are eligible for significant financial aid, depending on income.

The Vermont Health Connect Web site — vermonthealthconnect.gov, which Southwick recommends — provides a subsidy calculator to figure out how much financial aid individual Vermonters can expect.

For some, the speculation about the costs of the different plans is unnerving. Heidi Anderson, of St. Albans City, is a self-employed technical writer, who has many questions about the change. She said she’s just waiting to see how the exchange works.

“I’m looking to actually see it in practice,” she said.

The Chamber’s forums, one was co-sponsored by the Swanton Chamber on Monday night, didn’t go unappreciated. Anderson said not only did Southwick and Charlesworth answer many of the questions she came with, but also that other topics she hadn’t thought of had been raised.

Northwestern Medical Center CEO Jill Berry Bowen said public forums like the ones this week are vital to navigating the changes to health care. While there are many concerns, she said, the changes are really about providing health care for everybody.

“There’s so many unanswered questions,” said Berry Bowen. “We’re going to be there for the community no matter what. The bottom line is it’s about access for everybody.”

People buying health care through the exchange aren’t the only ones focused on upcoming changes. At Franklin County Home Health’s 44th Annual Meeting on Wednesday, the keynote speaker’s presentation focused on the health care changes and how they might impact home health providers.

J. Churchill Hindes, vice president for accountable care at Fletcher Allen Health Care, spoke about the history of change in the health care community, and how being able to adapt to those changes is key to an organization’s success.

Speaking to many home health providers, Hindes said the new health care requirements will now mean many more patients will be insured, changing the way the financial side of the practice works.

“We’re going to be paid in a fundamentally different way,” Hindes said.

Hindes said strong leadership from the bottom up in an organization will help pave the way to adapt to the changing landscape of home health care. Having worked with many of the Franklin County Home Health leaders, he was optimistic about the organization moving forward.

The dialogue on health care reform will continue, Southwick said. U.S. Rep. Peter Welch will be in St. Albans on Thursday, Sept. 26, at 9 a.m. the Elks Club in St. Albans, along with state and federal officials to continue answering questions about the exchange.

Southwick urged people to use the Chamber as a resource. He and Charlesworth are trained to answer questions about the complicated process, as well as being able to sit down with people and help them sign up through the exchange.

The Vermont Health Connect exchange officially opens up on Oct. 1. Individuals and businesses have until March 31, 2014 to sign onto the plan, or they will be ineligible for insurance coverage until October 2014. People signing up before 2014, will begin see coverage starting Jan. 1, 2014. Beginning in 2014, the exchange will be the only place for individuals and small businesses to purchase insurance.

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The Messenger will continue to follow discussions of health care coverage changes and in the weekend edition will provide specifics regarding individual’s and small businesses’ obligations.

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