While it’s recently been announced that Vermont will have to pay the highest premiums in the nation for health insurance for 2025, much of the tab for those struggling to pay will be picked up by taxpayers.
“This year, many Vermonters will be eligible for better coverage plans at lower premium costs due to increased federal subsidies,” the Department of Vermont Health Access stated in an email presser sent out Monday.
It states that to have insurance coverage starting on January 1, 2025, Vermonters must enroll with Vermont Health Connect by Dec. 15.
“Now is the time to check available plans and take advantage of health coverage savings available through Vermont Health Connect,” it says.
According to the U.S. Department of Health and Human Services, the federal government under the Biden Administration put much public resources towards buying down health insurance premiums.
“President Biden’s prescription drug law, the Inflation Reduction Act, was signed into law on August 16, 2022. This new law provides meaningful financial relief for millions of people with Medicare by expanding benefits, lowering drug costs, and strengthening Medicare for the future,” they report.
KFF,a heatlhcare industry publication, gets into the scope of the subsidies.
“Enhanced subsidies have cut premium payments by an estimated 44% ($705 annually) for enrollees receiving premium tax credits. If the subsidies expire, most Marketplace enrollees will see premium payment increase substantially,” they write.
Health insurance premiums keep going up even as other parts of the economy cool down. David Marlett, a professor of insurance at Appalachian State University told Marketplace, “As health care costs go up, to see a doctor, to get prescription drugs … that drives the health insurance premiums.”
Sticker price hidden
The plans include major public subsidies for Vermonters who qualify, which ultimately hides the true price of premiums from many low-income residents.
“For plan year 2025, an eligible individual who earns $40,000 a year could get the lowest-cost Gold plan for less than $1 a month – a savings of $1,172 each month. A family of four with a household income of $100,000 could get a Gold plan for $155.37 a month – a monthly savings of $3,044, or more than $35,000 per year,” it states.
As noted in VTDigger, most Vermonters never see the true price.
“More than 89% of Vermonters on those plans received some form of federal subsidy to pay for them, according to the 2024 data from the federal Centers for Medicare & Medicaid Services. After those subsidies, the average premium dropped to $243 a month, and Vermonters who received those federal subsidies paid an average premium of $178 a month,” their repor states.
Hospitals in financial trouble
Bruce Hamory, a medical doctor and consultant with the firm Oliver Wyman, said that the Green Mountain State’s “hospital systems and the state will see deep financial deficits.”
His report caused a stir when it called for a reduction in healthcare facilities and services statewide. Hamory has since denied that they are pressuring hospitals to close.
“As described in the report and presented to the public, OW has provided financial projections that account for Vermont’s concerning demographic trends. OW did not mandate or recommend any hospital closure, to the contrary we provided local communities and hospital options to examine in addressing critical gaps in care and financial challenges so that local healthcare is sustained.”
Health Insurance scandal
A Wall Street Journal report found that health insurance companies running Medicare Advantage programs have overcharged the federal government by close to $50 billion in false claims regarding their patients’ health.
Charity Care
Charity Care is federal law that all hospitals that take any public funds must adjust their billing to the patient’s ability to pay.
According to the health policy research KFF, it is barely a cost to current hospital budgets. They state, “Half of all hospitals reported that charity care costs represented 1.4% or less of their operating expenses in 2020, though the level of charity care varied substantially across facilities.”
