(St@teside Published May 26, 2006)

Vermont:

In May 2006, the Vermont Legislature and Governor Jim Douglas (R) reached agreement on a new program for Vermont 's uninsured called Catamount Health with the goal of assuring insurance coverage for 96 percent of Vermont 's adults.

•  Catamount Health

• Subsidized health plan available only to Vermont 's uninsured.
• The state will subsidize premiums and cost sharing on a sliding scale for individuals under 300 percent of the federal poverty level (FPL).

•  The benefit package will resemble the standard Blue Cross Blue Shield PPO with a $250 deductible.

•  Financed through a combination of individual premiums, an assessment on employers who do not offer health insurance, new tobacco taxes, and possible federal matching funds.

•  Must align with the Vermont Blueprint for Health's Chronic Care Initiative, a collaborative approach that seeks to improve the health of Vermonters living with chronic diseases and prevent the spread of chronic disease utilizing the Chronic Care Model as the framework for system changes.

•  The health care debate in Vermont acknowledged the fact that the majority of health care dollars are consumed by individuals with chronic diseases such as asthma and diabetes. The legislature and the Governor recognized the potential to control the growth of health care costs and improve the quality of care delivered in the state by making chronic care management a focus of reform efforts.

•  Employer Premium Contribution Assessment

• Requires employers who do not currently contribute to their employees' health care costs to help pay for the program costs.
• These employers are assessed $365 per FTE in the first year (with increases allowed as premiums change) on three groups of employees:

1. those who are not offered health insurance by their employer;
2. those who are not eligible for the health insurance offered by their firms; and
3. those who are eligible for coverage through their employer plans, but choose not to enroll and are therefore uninsured.

Additional Information

• Overview of Vermont Legislation
• Details of the Legislation
• Catamount Health Questions and Answers
• Employer Assessment Schedule
• Legislation