WINOOSKI — A newly formed coalition of labor organizations, consumer groups and non-profits is asking lawmakers to consider expanding the state’s Dr. Dynasaur program for Vermonters through age 26, a request that has the backing of House Speaker Shap Smith.
The group announced its new Dr. Dynasaur 2.0 campaign to convince lawmakers to study the expansion of the publicly funded health insurance program for Vermont kids and lower-income pregnant women at a Winooski news conference Wednesday. The program currently covers children through age 18.
By expanding the program through age 26, Vermonters and the state’s employers could save thousands in premium costs, Main Street Alliance State Director Lindsay Deslauriers said.
“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,” she said.
“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 funds 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.
Raising the eligibility age of Dr. Dynasaur to 26 would help make “expensive family plans obsolete in Vermont,” and would help remove the burden of covering a large section of the workforce from employers, Deslauriers said. About 120,000 Vermonters would be able to shift from private insurance plans to Dr. Dynasaur.
“For those small employers, many of whom we work with at Main Street Alliance, who can’t provide health insurance to their employees — not because they don’t want to, not because it’s a matter of being a good or bad employer, but because the cost of health insurance is prohibitive — for those employers and their employees, this plan will cover a significant portion of the workforce — everyone up to their 27th birthday,” she said.
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 below $48,000 per year to be eligible. Families of three and four must earn less than $60,000 and $73,000 per year, respectively.
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 for 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.
“Those are all goals that we should all share as Vermonters and those are goals that we will push forward in this study. Let’s be clear — this study is important because what it’s going to ask is, is this achievable? Can we put together a system that … is less expensive than the one we have now and works better than the one we have now?” Smith said. “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.”
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.
Wes Hamilton, owner of Mule Bar where the news conference was held, 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 simply doctor’s visit wasn’t a question.”
Now, Hamilton employs many 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,” he 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. The simple ramifications of having quality coverage for young people is, to me, it’s pretty apparent.”
Removing dependents age 26 and under from family health care plans could help lower premium costs 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, but lawmakers should prioritize funding for the study, he said.
“It seems to me that if this is something that could save Vermonters — as a whole — money, and if it’s something that could be an economic development tool by attracting young Vermonters and retaining young Vermonters, and if it could make the system more simple, then that’s worth studying from my perspective,” Smith said.
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,” she 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, Vermont NEA, Vermont State employees Association, the American Cancer Society and Voices For Vermont’s Children, among others. Vermont NEA, which represents more than 9,000 educators in the state, has contributed $130,000 toward the campaign. Main Street Alliance has provided another $30,000.
Dr. Dynasaur 2.0 campaign director Peter Sterling said he expects it will take at least $1 million to pay for a public education media blitz and convince lawmakers to study the proposal.
“I don’t see how you spend any less than that to fully pass it,” he said.