Health Care Chief: Problems At Exchange Hurting Support For Single Payer

Aug 1, 2014

The governor’s chief of health care reform, Lawrence Miller, says the ongoing technical problems at the state’s health care exchange have undermined political support for a single payer system. But Miller says the administration has more than enough time to rectify this situation.

Gov. Peter Shumlin wants to implement a single payer system in Vermont in 2017. For this to happen, lawmakers would have to support a financing plan for the new system and the state would need to get a waiver from the federal government.

Since its launch last fall, the state’s health care exchange, known as Vermont Health Connect, has encountered a series of technical problems.

The online payment system for businesses has never worked, many people have had to make numerous phone calls to apply for coverage, and thousands of individuals are unable to make any changes to their applications because the system won’t let them.

Health care chief Miller says a single payer system is much simpler than the current “exchange” based model.

“No eligibility determinations, no enrollment to be done. If you’re a Vermont resident you’re covered.

"Do I agree that it has undermined support? Yes, I think given the perspective of people today, they are clearly intimidated." - Health Care Chief Lawrence Miller on why problems at Vermont Health Connect have hurt support for single payer

Simply hiring a claims payment processor to take care of everybody,” said Miller. “So part of the reason that we’re going down this path is that today’s system is incredibly complex, not particularly fair and not particularly transparent.”

A number of lawmakers who strongly back the single payer approach say that the ongoing technical problems at the exchange have undermined political support for their plan. Miller thinks they’re right.

“Do I agree that it’s undermined support ? Yes I think given people’s perspective today they’re clearly intimidated,” said Miller. “I think we have to in January be prepared to lay out a clear operations plan that demonstrates why the statement I just made about it being simpler and lower risk is true.”

The administration isn’t expected to outline its single payer funding options until January. Under state law, this plan was due almost a year and a half ago.

Miller says he’s convinced that a new $2 billion revenue package can be put together that won’t hurt Vermont’s business climate.

“I do, but right now that’s at the level of a hunch based on macroeconomics,” said Miller. “As you know, we’ve retained analysts to go through and do a good microeconomic simulation on multiple iterations to really understand the impact of various choices that the Legislature will have in pursuing the financing strategy.”

Miller says he’s hopeful that the outstanding technical problems at the exchange will be fixed before the next open enrollment period begins in the middle of November.