Green Mountain Health

Senate Passed Amendments to H.524

May 18, 2005

By 2009, Vermont will have an integrated health care system which provides all Vermonters with access to affordable, high quality health care that is financed in a fair and equitable manner.

This goal will be achieved through development of a long-term strategy for integrating the health care delivery system, controlling costs, and coordinating health care policy, planning, and regulation.

Green Mountain Health will provide primary and preventive health care coverage to all uninsured Vermonters beginning July 2006

• Benefit package recommended by the Legislative Commission on Health Care Reform with approval by the legislature
• Medicaid-eligible uninsured would be encouraged to enroll in Medicaid

Green Mountain Health will include hospitalization by July 2009

• Expansion occurs upon reaching cost containment and performance benchmarks

• All Vermonters will have, at a minimum, a common benefit plan, including hospital coverage
• Vermonters will be able to chose between Green Mountain Health and any qualified private insurer

Cost Containment – The goal is to reduce the rate of growth of health care spending to support expanded access.  Cost control initiatives address financing, delivery, and quality of health services.  These cost containment measures include:

· Global budgeting of hospitals

· Chronic care initiative

· Consumer access to health care price and quality information

· Health care information technology initiative

· Alignment of health care professional reimbursement with best practices and outcomes

· Health care purchasing pool

· Prescription drug initiatives, including statewide preferred drug list, pharmacy discount plan,  pharmacy benefit manager regulation, and manufacturer price disclosure

· Options for medical liability self-insurance; Safe apology

· Healthy lifestyles insurance discount

· Assessment of cost containment progress

Financing -  all are covered, all contribute - reducing the cost shift

Health Care Tax - An estimated 3% payroll tax will be assessed with an exemption for all businesses on the first $25,000 of payroll to assist our smaller businesses. There is no tax on the payroll of insured employees or on employees age 18 or younger.

The tax will be assessed on:

• employees without health insurance
• employers whose employees do not have health insurance
• employers whose employees are on Medicaid or similar state programs

Studies: Economic impact, financing options, governance, and administration