BURLINGTON, Vt. (WCAX) We are taking a closer look at what rising health care costs in Vermont mean for you.
Last week, we told you if you get your insurance through Vermont Health Connect, you will likely be paying more. The Green Mountain Care Board approved an average increase of 12.4 percent for Blue Cross Blue Shield of Vermont and a 10.1 percent increase for MVP. But even the Green Mountain Care Board says those increases are unaffordable.
Vermonters are frustrated by rising health care costs. It doesn't matter the insurer. Just ask Debbie Safran who is on her husband's.
"We actually got married so that I could get on his insurance," Safran said. "Which is kind of a ridiculous reason to get married but his insurance was more affordable than mine."
The Starksboro woman says she hears from other people who are sick of the premiums going up and fighting with their insurance company to get care covered.
"Health care should be-- you go to the doctor, you give them the card, and you leave. It shouldn't be this whole mess of-- are we going to have to pay this out of pocket? Are we going to get reimbursed for our expenses? And we didn't actually go to the doctor at all last year because we were so worried about what we were going to have to pay out of pocket," Safran said.
"Quite frankly, it's as simple as Vermonters just can't afford it," said Mike Fisher, the chief health care advocate for Vermont Legal Aid.
Fisher says he's worried that as health care rates continue to go up, people will have to choose plans that don't give them the coverage they need.
"There's clear evidence that when rates go up like this, more and more Vermonters are forced into plans they can't afford to use. That is, they're underinsured. They pay their premiums, but they have deductibles of $10-15,000 and they can't afford to get the care they need," Fisher said.
With the recent Vermont Health Connect rate increases, he's concerned about small businesses in particular and Vermonters just above subsidy levels.
"Those Vermonters will feel these increases most substantially," Fisher said.
It's not just businesses. Fisher says he's concerned about Vermont's nonprofits.
Beth Stern from the Central Vermont Council on Aging says a 15 percent increase would cost her agency an extra $37,000.
What does that translate to? Ten-thousand meals on wheels, 1,800 hours of respite for a caregiver of someone with dementia, hiring a part-time nutrition assistant or someone to help clients figure out Medicare Part D insurance.
Stern says because they aren't getting money from the feds or the state to offset health care increases, the extra $30,000 they have to pay now has got to come from somewhere. She doesn't think the Green Mountain Care Board's limits went far enough.
"I'm not trying to put a positive spin on this because there isn't a positive spin. These are terrible numbers," Green Mountain Care Board Chair Kevin Mullin told WCAX News last week.
Mullin said they weren't happy about the Health Connect increases but had to consider the financial impact to insurers, too, which claimed they were losing money on expensive drugs and growing demand for services. If the insurers lose too much money, they could drop out.
Fisher admits the board has a tough job to balance the needs of the public and insurers but says it's Vermonters who are paying the price.
"Big rate increase like this has a real impact on Vermont families," Fisher said.
The health care advocate also said he's concerned that continued rate increases will also set the state back on efforts to change to a system of care that rewards doctors for keeping people healthy. He says if people can't afford to get care, that won't work.