Vermont Action Center

 
ACS legislative goals:

• To eliminate the pre-existing conditions clause which excludes individuals with cancer from coverage for one year under Catamount Health.
• To keep Catamount Health affordable by not increasing premiums and co-pays
• Underinsured Vermonters are struggling with rising health care costs; paying high co-pays and deductibles, coping with caps on medical treatment and surgeries allowed, and paying out-of-pocket for pre-existing conditions.  It is critical that underinsured individuals in high-deductible plans of $3,000 and higher or who spend more than 10 percent of their income on health care be allowed to enroll in Catamount Health without the one year waiting period.

ACS legislative outcomes:

1.  Catamount Update:
Pre-existing conditions:  H.140 was introduced to remove pre-existing conditions from CH; the bill was assigned to House Health Care Committee, where it received a hearing.  Unfortunately the bill did not pass out of committee. 
Reducing the one year waiting period:the state will seek an amendment to the "Global Commitment" waiver to reduce the waiting period for Catamount and VHAP from 12 to 6 months. 
Exempting self-employed individuals who lose their business from the 12-month waiting period for eligibility - dependent upon approval of CMS waiver amendment
Underinsured:  lowering the high deductible threshold from $10K to $7500K as an exemption to the 12 month waiting period and allowing self employed individuals who close their business to also not have to go through the waiting period.
Affordability:  We successfully blocked any increases to premiums, co-pays, and deductible to Catamount, Dr. Dynasaur & VHAP.
Designating depreciation as an allowable business expense for purposes of income calculation under CH, VHAP & ESI (this is very important to farmers and self employed people in the trades like plumbers). In addition, there are no increases to Dr D, VHAP or Catamount Health's premiums, co-pays or deductibles.

2.  Oral Chemotherapy Parity: Requires health insurers that cover cancer chemotherapy treatment to provide coverage for orally administered chemotherapy that is at least as financially favorable as intravenous or injected chemotherapy under the insured’s plan. Directs BISHCA to study the impact on health insurance premiums prior to the requirement taking effect (April 1, 2010).