Vermont Moves Toward Universal Coverage

In early May, the Vermont Legislature and Governor Jim Douglas (R) reached agreement on a new program for Vermont’s uninsured called Catamount Health. Catamount Health introduces a new, subsidized health plan into the commercial market available only to Vermont’s uninsured. The state will subsidize premiums and cost sharing on a sliding scale for Vermonters 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.

Catamount Health is 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.

Although the program remains voluntary, Vermont estimates that approximately 25,000 of the 60,000 uninsured persons in the state will take up the new product. If the state’s set goal of 96 percent coverage is not reached by 2010, the state will consider imposing mandatory insurance requirements.

Catamount Health is one part of a much larger piece of legislation. The legislation sets out guiding principles for affordable access to care for all Vermont residents and sets guidelines for cost containment that focus on chronic disease prevention and effective management. Other provisions in the legislation include:

• Optional premium assistance for individuals with access to an approved employer-sponsored health insurance plan who are eligible for or enrolled in the Medicaid program, Dr. Dynasaur (the State’s Children's Health Insurance Program), the Vermont Health Access Plan (VHAP)[1], or are uninsured with incomes under 300 percent FPL.
• Increased Medicaid and VHAP reimbursements: Provider evaluation and management procedures (generally office visits) will be reimbursed at a level equivalent to 2006 Medicare rates. Payments to providers participating in the care coordination program will also be increased. In addition, to the extent permitted, the state will increase rates for providers participating in Medicaid and other state programs using quality and performance measures developed by the Vermont Blueprint for Health.
• Discounts of up to 15 percent of premium for small employers whose employees adhere to health promotion and disease prevention programs.

For additional information on Vermont’s Legislation, please visit: