The administration of Vermont Gov. Peter Shumlin is encouraging state employees with children to consider dropping their kids from their parents’ health care plan and instead enrolling them in Dr. Dinosaur, Vermont’s version of the state-federal health insurance program for low-income children.

The administration says the change could save state employees a lot of money — and it could reduce the state’s health care costs by millions of dollars.

Several weeks ago, 2,100 state employees with children who meet certain income thresholds received a memo from the Shumlin administration outlining how this option would lead to savings both for the employee and for the state.

Children in households earning less than 300 percent of the federal poverty level are eligible for Dr. Dinasaur. For a household of three people, the income cap is roughly $56,000.

An example: A single parent with two kids right now pays about $4,500 a year for  family coverage from the state employees’ health plan. If the kids are shifted over to Dr. Dinosaur, the parent could buy an individual policy and save about $2,000 a year. The state would save about $10,000 on this family’s health insurance.

If half of the eligible state employees made this change, Vermont could save more than $5 million a year.

“It’s an opportunity that we wanted state employees to be able to make a choice about,” said Mark Larson, the commissioner of the Department of Vermont Health Access. “It does provide an opportunity for coverage to be more affordable for a family and it does provide some opportunity for the state to provide health coverage for the family at less expense to the state.”

The move doesn’t require any new legislation or regulation. It’s a matter of making the state employees who already meet the income requirements aware that they are eligible.

The effort has some detractors, though. Jeff Wennberg,Ěýexecutive director of Vermonters for Health Care Freedom, a group that opposes Shumlin’s proposal to implement a single payer system in Vermont,Ěýsays the plan, by involving the kids of state employees, goes beyond the original concept of Dr. Dinosaur.

“I think a lot of Vermonters ought to take a close look at this and try to decide whether they really feel comfortable shifting some or ultimately all of the coverage that right now is provided privately, onto taxpayers. Is that a direction that we really do support?” Wennberg said.

But Larson says the plan is consistent with the initial policies of the Dr. Dinosaur program.

“There has been no change to the eligibility of Dr. Dinosaur to be able to provide this opportunity to state employees,” said Larson. “This is not an expansion. This is just an option that has historically been available, and we’re simply providing information about it.”

Larson points out that  the federal government pays roughly 70 percent of the costs of the Dr. Dinosaur program, allowing Vermont to save on the costs of insuring state employees’ children.

A number of other to enroll the children of qualifying state employees onto the federal CHIP program.

This story is part of a reporting partnership that includes ,Ěý and Kaiser Health News.

Ńîąóĺú´«Ă˝Ň•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

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Vermont is the only state in the nation a single payer health system. That could take a while, though. And in the meantime, the state has to set up an insurance exchange to comply with the Affordable Care Act.

While some states are still struggling with the basic question of whether to do their own exchanges, Vermont is moving ahead at a rapid clip, digging into the details of how much various health plans will cost on its exchange.

The Green Mountain Care Board this week released the that will be available to all individuals and small businesses in January 2014.

Consumers will have a range of options with different deductible levels, co-payment requirements and caps on out of pocket expenses.

Under the Affordable Care Act, there are four levels of coverage; platinum, gold, silver and bronze.  The benefit package is the same in each category, but the costs consumers will have to pay when they need health care services are different at each level. And this factor will influence the premium cost of the policy.

For example, the annual deductible in the platinum plan is $250 – in the bronze plan it’s almost $2,000. The cap for out-of-pocket medical expenses in the platinum plan is roughly $1,000 – in the bronze plan it’s just over $6,000.

The cost of a trip to the emergency room is capped at $100 under the platinum plan – it’s $350 under the bronze plan.  The cost of these services under the gold and silver plans fall between these two extremes.

The platinum plans, having the most generous benefits, would have the highest monthly premiums, and bronze plans would have the lowest premiums.

“What we’re trying to do is balance diverse needs of consumers and diverse desires of consumers by having a range of choices,” said Robin Lunge, the director of health care reform for Democratic Gov. Peter Shumlin’s administration.

Federal subsidies will be available for individuals and families with incomes up to 400 percent of the federal poverty level.  That’s roughly $45,000 a year of income for an individual and $92,000 for a family of four.

For example, an individual with a $30,000 salary and an employer who doesn’t offer health insurance would pay roughly $2,400 a year for the middle range policy known as the “silver” option – federal subsidies would pay the rest.

Lunge says the federal subsidies are a critical way to make coverage more affordable: “There are some affordability options in the federal law as well through the premium tax credits that should make insurance much more affordable for folks.”

The Green Mountain Care Board will now study the cost sharing plan developed by the Shumlin Administration, and it will seek public comments through Sept. 11 as part of that review.

This story is part of a reporting partnership that includes , and Kaiser Health News.  

Ńîąóĺú´«Ă˝Ň•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

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This story can be republished for free (details).

Vermont’s , established by state law in May 2011 and given new powers last spring, is taking over responsibility for virtually every aspect of health care in the state. This month’s project for the new regulatory board: How much hospital budgets should go up on an annual basis.

The board has established a cap on spending increases of no more than 3.75 percent annually. But as a group, Vermont’s 14 hospitals are seeking increases of roughly 7 percent for the coming 12 month period.

“We know there are some legitimate reasons that hospitals might need to grow higher than the 3.75 percent, most of those having to do with circumstances beyond their control,” said , the chairwoman of the Green Mountain Care Board.

The board may allow some increases above 3.75 percent, if the hospitals can prove that they are using the money to make investments that will lower costs in the long run.

But Wallack says the bottom line is that hospital spending needs to be kept under control: “We have a responsibility to hold down costs. So we’ll be looking at all of these requests with an eye toward how we can stay within that target, because we don’t think Vermonters can afford more than that.”

She says reviewing hospital budgets is a critical piece of the board’s efforts to help control health care costs in the state.

“I think this is significant in two senses,” Wallack said. “One is that hospital expenditures are a very significant portion of the total health care spending in Vermont.  The other is that this is the first time that the responsibility for hospital budgets and the responsibility for insurer rates has been in the same place.”

The board will hold a public hearing on the hospital requests in the middle of August. It will issue its ruling about the proposed spending increases in September.

Vermont is in the process of becoming the first state to have a single-payer health system. Gov. Peter Shumlin, a Democrat, to see the single-payer system implemented as early as 2016, a year earlier than previous estimates.

This story is part of a collaboration that includes ,  and Kaiser Health News.

Ńîąóĺú´«Ă˝Ň•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).