The future of Vermont Health Connect, the state's health care exchange, is a key issue in this year's race for governor, and the two major-party candidates say they would have different approaches to the exchange if elected.
Republican candidate Phil Scott says he has no confidence that the exchange will ever work properly, and he wants to dump it and have Vermont join the federal system.
But Democratic hopeful Sue Minter says moving to a federal model might be bad for Vermont consumers, and could end up costing the state more money.
There's no question that over the past few years the operations of Vermont Health Connect have failed to meet the expectations of the public and the Shumlin administration.
The administration says many of the problems can be traced to an accelerated timetable under the federal Affordable Care Act and the state's decision to replace its original IT contractor for the project.
But now the governor argues that many of the problems have been fixed, and that the backlog of cases pending at the exchange are at one of their lowest levels.
Republican gubernatorial candidate Phil Scott says he's seen enough, and if he's elected, he'll pull the plug on Vermont Health Connect.
"It's a fractured foundation that isn't really ever going to be fixed, from my standpoint, and I think it's time to find something that is fully functional." - Lt. Gov. Phil Scott
鈥淏ecause there are still a lot of folks across Vermont that are having problems with Vermont Health Connect,鈥� Scott says. 鈥淚t's a fractured foundation that isn't really ever going to be fixed, from my standpoint, and I think it's time to find something that is fully functional."
Democratic hopeful Sue Minter says the recent progress at Vermont Health Connect indicates that the exchange could finally be working as designed.
Minter thinks having a state-run exchange will provide Vermonters with better access to the system that handles complaints and coverage questions.
She also says moving to a federal model could be more expensive than running a Vermont exchange, because part of Vermont Health Connect includes a major IT upgrade to the state's Medicaid program.
Minter says those costs don't disappear if Vermont shifts to the federal system. That's why her strong preference is to stick with Vermont Health Connect.
"I absolutely am not ready to say, 'Let's jump to a federal exchange,' because that will incur more costs to Vermonters." - Sue Minter
"If I am to learn somehow that it can't become functional, then we'll make other plans,鈥� Minter says. 鈥淏ut I absolutely am not ready to say, 鈥楲et's jump to a federal exchange,鈥� because that will incur more costs to Vermonters."
Minter is also concerned that Vermonters who currently receive state subsidies for their health care premiums might lose them if Vermont shifts to the federal model.
Currently, the state appropriates roughly $6 million for premium subsidies and the money is applied directly when a consumer purchases a policy on the exchange.
Scott doesn't share these concerns, and says there ought to be a way to ensure that Vermonters continue to receive this assistance, although he says it might have to be done in a different way.
He points to an earlier system of subsidized care in Vermont called Catamount Health.
"I don't see where that would be problematic. We have been giving subsidies to Vermonters since Catamount. It would just be a different way in providing them, but I don't see that that would preclude us from offering subsidies,鈥� he says.
Minter is not convinced that the solution is that easy.
"I don't think it's simple. If it were simple, it would have been done,鈥� she says. 鈥淚t will require a parallel system, another IT system, or else a paper system to go in tandem with the federal system. So I would like to absolutely know the costs and impacts of any decision.鈥�
Scott says moving to the federal exchange is not the only option available to Vermont. He says he would also explore the possibility of joining with Connecticut to create a bi-state exchange program.
