- The Plan
- Why Dr. D 2.0?
- Dr. Dynasaur 411
- About Us
- Get Involved
Because publicly funded health insurance programs like Medicaid pays less than what health care providers need for many services, the shortfall is made up or “cost shifted” through the bills of private insurance companies like Blue Cross Blue Shield. These insurance companies then raise the rates for their private insurance products “cost shifting” their under reimbursement expenses to the people they insure.
According to a study of Vermont by the University of Massachusetts, from 2014-2017 medical payment rates as a percent of Medicare are 155% for commercial and 82% for Medicaid. The resulting cost shift to private payers from Medicaid is estimated to be more than $183 million for hospital and physician care.
The Dr. Dynasaur 2.0 campaign believes the State of Vermont must raise Medicaid’s reimbursement rate for health care providers to be paid fairly for treating enrollees in the program.
Currently, more than half of all Vermonters received their health insurance from a publicly funded source such as the military, Medicare, Medicaid or as a public employee.
Vermont has the second lowest uninsured rate in the nation at 3.7% or roughly 23,000 people. Of these uninsured, 1,342 are aged 0-18 and 4,567 are aged 19-26 representing roughly 25% of the uninsured population.
Most uninsured Vermonters are among the poorest Vermonters. For example, 2,370 of the uninsured Vermonters aged 19-26 are in households with income limits under $16,243 for a single person or $33,465 for a household of four).
While Vermont has a strong record in ensuring its resident have insurance, many of those covered still face out of pocket costs such as deductibles, co-pays, co-insurance and out of pocket maximums that make seeking health care too expensive. These Vermonters are known as “the underinsured”- the have health insurance but effectively can’t get health care or have to limit the amount of care they seek because of cost.
The State of Vermont’s annual Household Health Insurance Survey defines someone as “underinsured” if:
The Survey also found that nearly one in three (27%) of privately insured Vermonters is underinsured. Shockingly, 63% of those aged 18-24 are underinsured, by far the highest of any age bracket:
And it’s the poorest Vermonters on private health insurance that are by far more likely to be underinsured: