By Kristen Fountain/VTDigger
For the third year in a row, the Green Mountain Care Board has approved double-digit increases in the cost of annual premiums for individual Vermonters and small organizations who purchase their health insurance plans on Vermont Health Connect.
The approved premium increases will affect both individual and small group plans available on the state-run Affordable Care Act marketplace in 2025, affecting approximately 70,000 people.
The state’s health care regulator will allow Blue Cross and Blue Shield of Vermont (BCBS) to increase individual premiums by 19.8% and small group premiums by 22.8% over this year’s rates, according to a Green Mountain Care Board press release. MVP Health Care, the only other insurer to offer plans on the marketplace, will be allowed to raise its individual premiums by 14.2% for individuals and 11.1% for small groups over 2024 rates.
Double-digit increases in premiums were also approved in these markets for 2023 and 2024.
“These rates reflect deep fundamental failures in our healthcare system and the immediate need for systematic change,” Green Mountain Care Board Chair Owen Foster said in a written statement. “Vermont must address its underlying healthcare cost structure, demographic and housing challenges, and transform its healthcare system if we are to alleviate the healthcare affordability crisis we are facing.”
The care board’s announcement noted that people who purchase a plan on the individual marketplace will continue to have access to expanded federal subsidies next year. Those subsidies would increase to cover the jump in prices. The board encouraged all individuals to explore their eligibility for that assistance.
However, the board acknowledged in the release that for purchasers of small group plans — generally small businesses and nonprofit organizations — and individuals whose income is too high to be eligible for subsidies, “the approved premium increases are painfully high.”
The board reduced each insurer’s request slightly based on the findings of its own actuarial consultants. However, the board largely accepted an amended increase request filed by BCBS of Vermont in July, in which they cited “extraordinary cost pressures” as the reason.
The Vermont Dept. of Financial Regulation had warned the nonprofit insurer that its reserve funds — which are used to cover higher than anticipated claims — were low enough to trigger a “company action level event,” a circumstance spelled out in state law that requires the insurer to come up with a plan to stabilize its reserves. BCBS of Vermont told the care board that it needed the larger premium increase for that purpose.
“While these rates are plainly unacceptable, the alternative of an insolvent insurer unable to pay for patient care was worse,” Foster said in his statement.
