Public Health Coverage Pushed For All Under 26

WINOOSKI — A new coalition of labor organizations, consumer groups and nonprofits is asking lawmakers to consider expanding the state’s Dr. Dynasaur health insurance program through age 26, a request that has the backing of House Speaker Shap Smith.

The group Wednesday announced its Dr. Dynasaur 2.0 campaign to persuade lawmakers to study the expansion of the publicly funded health insurance program for Vermont kids and lower-income pregnant women. The program currently covers Vermonters through age 18.

By expanding the program through age 26, insurance customers and the state’s employers could save thousands in premium costs, said Lindsay Deslauriers, state director of Main Street Alliance.

“Health insurance is expensive, and since the implementation of the Affordable Care Act, even with insurance, health care is expensive,” she said. “Premiums are high, deductibles are high, out-of-pocket costs are high.”

“If we do nothing, by 2025 it’s estimated that premiums for a platinum family plan in the health care exchange will cost a Vermont family $41,000. This isn’t sustainable, and frankly, it’s a step back for Vermont,” Deslauriers said.

Dr. Dynasaur, launched in 1989, is funded by both state and federal money through the State Health Care Resources Fund. Federal funding comes from Medicaid and the State Children’s Health Insurance Program.
Deslauriers said part of the study would determine if federal money could help cover the costs of expansion.

The coalition is also proposing removing all income caps for eligibility, which currently are set at 300 percent of the federal poverty level. Under the current program, a family of two must earn less than $48,000 a year to be eligible. Families of three and four must earn less than $60,000 and $73,000 a year, respectively.

The group didn’t offer estimates of the expense of such an expansion or the study it is requesting. About 120,000 Vermonters would be newly eligible for the Dr. Dynasaur program.

Smith, a Democrat who is not seeking re-election and recently withdrew from the gubernatorial campaign because of a family health issue, gave his full support to studying the fiscal impacts of expanding the program.

“It has been incredibly successful, and it has improved the public health of Vermont’s children while being affordable,” he said. “We can do better than that. We know that we can expand this program to all Vermonters under 26 and we can make it even better for young Vermonters in this state.”

Lawmakers should be looking at ways to reduce the cost of health care for Vermonters and employers, Smith said, and finding ways to attract and retain young people in the state.

He said the study will look at whether the state can put together a health insurance system for younger Vermonters that is less expensive than the current one and works better.

“That is a question that we have to ask, it is a question that we will ask, and I look forward to putting something on the governor’s desk by the end of this legislative session that moves us forward to ensuring that all Vermonters under 26 have health care coverage no matter their income, no matter their status,” Smith said.

University of Vermont student Lachlan Francis said the expansion would be appealing for young Vermonters — or potential young Vermonters.

“I hope to stay in Vermont after graduation, but with high costs of living and low entry-level wages that often are not paired with an employer plan, high deductibles, high premiums and high drug prices quickly become a barrier to access to health care,” he said at the news conference Wednesday.

Wes Hamilton, owner of Mule Bar in Winooski, where the news conference was held, and co-owner of Three Penny Taproom in Montpelier, said he struggled to obtain health insurance in his 20s until his mother helped him with a catastrophic plan.

“Pretty much, if something horrific happened, at least they wouldn’t turn off the machine on me, I guess, in the hospital,” he said. “Paying rent and putting gas in the car to get to work was nearly impossible, so paying for medications or a simple doctor’s visit wasn’t a question.”

Now, Hamilton employs workers under the age of 26, and some do not have sufficient health coverage, he said.
“I can tell you that there are a number of younger people employed in the service sector in the food and beverage industry, and they don’t have insurance and they are going to work and they’re making your coffee in the morning and they’re serving your food when you’re at a restaurant,” Hamilton said.

“We don’t want them there, you don’t want them there, but they have no choice because they need to work in order to afford the bills that they do have,” he said. “The simple ramifications of having quality coverage for young people is, to me, it’s pretty apparent.”

Removing dependents age 26 and younger from family health insurance plans could help lower premiums enough to prevent them from being subject to the so-called Cadillac tax, a 40 percent excise tax on high-end insurance plans slated to begin in 2018, Smith said.

“That has the possibility of saving Vermonters who have family plan coverage now a great deal of money and saving Vermont employers a great deal of money as well,” he said.

There is “not a ton of money floating around,” the speaker acknowledged while arguing that lawmakers should prioritize funding for the study because of the possible benefits.

Deslauriers said the coalition will not pursue the proposal beyond the study if it is not more cost-effective than the system currently in place. That promise is reminiscent of the pledge Gov. Peter Shumlin made when pushing for a single-payer health care plan that was ultimately shelved because of its high cost.

“We’ve done enough work to feel confident to request a study,” Deslauriers said. “We wouldn’t be here if we didn’t have the expectation that the cost of expanding Dr. Dynasaur will be less than our current system. If we find that that’s not the case, we will not pursue this beyond the legislative study.”

The coalition includes AARP, the unions for Vermont’s teachers and state employees, the American Cancer Society and Voices For Vermont’s Children, among others.

The Vermont NEA, which represents more than 9,000 educators in the state, has contributed $130,000 toward the campaign. Main Street Alliance has provided $30,000.

Dr. Dynasaur 2.0’s campaign director, Peter Sterling, said it will take at least $1 million to pay for a public education media blitz and lobbying to persuade lawmakers to study the proposal.

“I don’t see how you spend any less than that to fully pass it,” he said.