Vermont's new health care exchange is just months away from getting off the ground and a new startup says it has what it takes to compete with established insurance providers. But the Vermont Health Co-op has hit a major roadblock.
The Vermont Health Co-op has been organizing for a year and says it has a model that works. CEO Christine Oliver made her case to the public Wednesday afternoon. The move comes in response to a state ruling that argues otherwise. Last week, the state Department of Financial Regulation denied the company a license to offer insurance. The ruling argued the co-op's rate would be higher than other providers and would not attract enough customers to stay afloat.
Oliver says her model is sound and would give customers more options. She says the ruling came as a surprise.
"Probably the blindsiding of the decision itself, we've been working through the process for practically 10 months with the department of financial regulations, to get the denial with such a closed door seemingly attached to it was shocking," Oliver said. "Why in Vermont where we are leaders in health care reform, co-op capital of the world if you will, we can't find a way to make this work? I just can't believe that would be the answer here in Vermont."
Right now there are two providers on board to participate in the exchange including BlueCross BlueShield and MVP.
Oliver is hopeful the Department of Financial Regulation's Commissioner Susan Donegan will reconsider the ruling and let Vermont Health Co-op become the third.
I asked Oliver if she felt the state tried to influence this decision or if there was "pressure" from BlueCross and MVP leading to the license denial. She tells me she can't explain the rejection, saying there was pressure "somewhere" and the decision did not make sense to her.
The exchange-- called "Vermont Health Connect"-- is where self-insurers and businesses with 50 or fewer employees will need to purchase their insurance as part of the new federal mandate. That plan gets underway this October.