Health Care Coverage – Vermont

The state of Vermont has one of the lowest proportions of uninsured people in the country, and virtually all the state’s children are covered. This is due to a number of programs promoted and backed by Howard Dean, governor of Vermont from 1991 to 2003.

Vermont’s Office of Vermont Health Access (OVHA) administers Medicaid and the state’s other Health Access/Health Insurance programs.

TheVermont Health Access Plan provides an array of health benefits to state residents, including children, low-income adults, and the elderly. Vermont also provides medical coverage for adults with incomes below 150% of the poverty line and requires health insurance companies to sell policies to residents, regardless of age or medical history. According to the state, there were approximately 36,000 people enrolled in VHAP managed care and prescription benefit programs in 2004, and another 95,000 traditional Medicaid beneficiaries. In total, that is more than one-fifth of Vermont’s population.

Undera program called Dr. Dynasaur, the state offers medical and dental care to children under age 18 from families with incomes up to 300 percent of the poverty line, and pregnant women from families with incomes up to 200 percent of the poverty line.

The current governor, Jim Douglas, has proposed changes to the program, which is projecting a shortfall of at least $60 million by 2006. Part of the shortfall is due to rising health care costs, but most of it is due to cuts in federal Medicaid funding. The state has applied for a federal Medicaid waiver under which the state would assume all risks for caseload growth and cost increases in exchange for a firm federal commitment to the amount of money it will receive over the next five years, and greater flexibility to allocate the money across health programs. One cost-cutting measure proposed is to end VHAP eligibility for people with access to employer-based health coverage, instead offering a subsidy of up to half the premium cost.