Vermont announces rates under health 'exchange'

Dave Gram, Associated Press

MONTPELIER, Vt. (AP) -- Vermont regulators on Monday announced monthly rates for health insurance to be sold under Vermont Health Connect, the health insurance exchange being set up to comply with the federal Affordable Care Act.

Middle- and upper-class consumers who begin buying through Vermont Health Connect when it takes hold of Vermont's individual and small-group health insurance markets in January won't notice much difference in costs of insurance and benefits provided, according to the state's largest insurer and the chairwoman of Vermont's Green Mountain Care Board, which approved the rates.

But for those of moderate and lower incomes, federal tax credits and state premium subsidies designed to help pay the cost will make health insurance a better deal than it is now, GMCB Chairwoman Anya Rader Wallack said.

"For those who qualify for the tax credits and premium subsidies, there's a pretty big difference," Wallack said. "In terms of just comparisons with prices in the marketplace (today), the difference is less dramatic," she said.

Kevin Goddard, spokesman for Blue Cross Blue Shield of Vermont agreed, calling the rates to be charged when people buy his company's insurance through Vermont Health Connect "comparable" to what they would pay without the exchange in place.

Rates being offered for the benchmark so-called "silver plan" for individuals will be a bit less than $395 per month for individuals buying a Blue Cross Blue Shield product, and $410 a month for those buying a similar policy form MVP Health Care. Those prices are similar to what an individual pays now for a similar suite of coverage options, Goddard said.

Lower-income Vermonters will get federal tax credits and state premium subsidies to cover some of the costs. For someone making the median individual income of about $34,000 a year, that will reduce the cost of the Blue Cross plan to about $230 a month, and the MVP plan to $252.

The Blue Cross family plan will cost $1,111 a month through Vermont Health Connect. For MVP it will be $1,151.

The rates described by the Green Mountain Care Board are for a mid-range health insurance offering what it terms a "silver level" plan. Other plans range from bronze to platinum. Bronze will have lower monthly premiums but higher co-pays and deductibles; platinum plans will have higher rates but lower out-of-pocket costs.

All plans offered on the exchange must offer certain "essential health benefits," including outpatient care, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse disorder services, behavioral health treatment, prescription drugs, rehabilitative services, laboratory services, preventative care and pediatric services, including oral and vision care for children.

The Green Mountain Care Board said it shaved 4.3 percent off the rates initially proposed by Blue Cross and 5.3 percent off the rates offered by MVP. But Wallack said more needs to be done to control the cost of insurance and of the health care it buys.

The reductions will save Vermonters money, but "the underlying cost of health care and health insurance remain alarmingly high, and we have to redouble our efforts to address this problem," she said.