Heading toward the Nov. 1 open enrollment period for Vermont Health Connect, Gov. Peter Shumlin applauded the dramatic improvements in the system and the expansion of more affordable coverage available to Vermonters.
“What we’ve been able to do is take a huge federal investment and accomplish some great things for Vermonters,” Gov. Shumlin said. “We’ve expanded coverage, and now Vermont has one of the lowest uninsured rates in the country. We were also able use federal dollars to upgrade an aging state Medicaid technology system and ease Vermonters’ access to the program. I’m proud that we were able to use federal dollars to solve problems that otherwise would fall on the backs of Vermont taxpayers.”
Gov. Shumlin highlighted critical improvements to the Vermont Health Connect system:
Nearly nine out of 10 Vermonters requesting a change of circumstance to their coverage—adding a new baby to their policy, for example—experience a smooth process. This is VHC’s best performance to date on this key metric, and improvements continue. In fact, VHC has been able to reduce the backlog of change requests from 10,000 last spring to about 1,200 today.
Eighty-five percent of all Vermonters’ requests are being processed within 10 days, up from 49 percent a year ago.
The error rate on transactions dropped from 3.5 percent in May to 2 percent in September.
Staff are now able to resolve urgent and complicated cases much more quickly. The number of “escalated cases”—those that cause Vermonters longer delays and frustration—has dropped from more than 250 earlier this spring to only 19.
“A client came to me who had lost her employer-sponsored plan,” said Melanie Clark, a Vermont Health Connect navigator at The Open Door Clinic in Middlebury. “She was so happy with her Vermont Health Connect coverage that she brought her brother, an uninsured farmer. He then came back with his son, who in turn returned with his girlfriend and his girlfriend’s sister to enroll them in plans. Five individuals are now enrolled in a health insurance plan that fit their needs and budgets.”
Vermont has one of the three lowest uninsured rates in the nation, at only 2.7 percent. Gov. Shumlin said more than one in three Vermonters is now covered by a Vermont Health Connect health plan—either a qualified health plan (QHP) or Medicaid for Children and Adults (MCA). As of July 2016, approximately 220,000 Vermonters possessed such coverage. More than 30,000 additional Vermonters also receive health coverage from the Department of Vermont Health Access through Medicaid for the Aged, Blind, and Disabled (MABD).
In addition, VHC is reaching the challenging “young invincible” demographic. A 2014 Vermont Household Health Insurance Survey found that 25- to 34-year-olds were more than twice as likely as any other age group to be uninsured; they are now enrolling through VHC at a much higher rate—one in five new enrollees falls into that hard-to-reach age group.
Gov. Shumlin also noted that more than three-quarters of VHC-managed QHP enrollees receive financial help (subsidies) to make premiums and/or out-of-pocket costs more affordable. That is up from approximately two-thirds last year.
One area of concern has been slow telephone response time to consumer questions and inquiries. Gov. Shumlin met earlier this week with the CEO of Maximus, the company spearheading the call center for VHC, and was assured that staffing levels would be increased and the company planned to have the problem resolved in the coming weeks—well ahead of open enrollment.
Commissioner Steven Costantino of DVHA updated a legislative oversight committee on the improvements, but said the administration continues its push for even better service for Vermonters. “I will not rest until every customer gets the service they deserve,” he added.
Vermont Health Connect’s 2017 open enrollment window will begin Nov. 1 and run until Jan. 31. Vermonters who experience a life change that results in a need for health insurance may qualify for a mid-year special enrollment period. Customers and potential applicants can call 855-899-9600 or click on VermontHealthConnect.gov to learn more or to find a Vermont Health Connect navigator to guide them through the process.