This review is by Kevin Mullin, who will retire on Aug. 4 after five years as chair of the Green Mountain Care Board. Previously, he served 19 years as a state representative and state senator.

As I prepare for retirement and the Green Mountain Care Board enters its busy summer administrative season, the impact of Vermonters weighs heavily on me.

The last two years have been very difficult. This pandemic has caused unprecedented hardship for Vermonters and families as well as our hospitals and staff. This summer, as the agency reviews health insurance coverage and health care budgets for 2023, the country is facing the challenges of rising costs that affect everyone.

I know that the decisions before the board will be very difficult. Our fragile health care system needs stability today and stability for the future.

The board’s review of health insurance costs determines how much Vermonters covered by individual or small health plans pay each month for their insurance. In making these decisions, we are charged with considering “if the cost is reasonable, promotes good care and access to health care, protects insurance coverage, and is not unfair, unjust, unfair, misleading, or contrary to Vermont law.”

In other words, we have a responsibility to balance affordability and opportunity for consumers and ensure that insurance companies earn enough money to cover the cost of caring for their members and maintain the necessary savings. Difficult times like this only increase the tensions that exist for these reasons.

I know that premium increases will hurt families and businesses that are struggling. As a former small business owner, I see employers struggling with labor shortages, supply chain issues, and rising commodity prices. Hospitals, which make up nearly half of Vermont’s health care costs, are facing these challenges — which are seen around the world. These additional costs are passed on to consumers through insurance premiums that they pay.

I also worry about gridlock in Washington and the loss of much-needed federal aid to consumers. During the pandemic, the federal government provided assistance through special insurance subsidies to people who purchased health insurance through Vermont Health Connect.

Unfortunately, as Chief Health Care Advocate Mike Fisher recently wrote, this federal aid is set to end at the end of this year. The loss of subsidies will make rising premiums even more painful.

Following years of hospital funding and efficiency, Vermont’s hospitals are facing financial challenges, putting us at risk of losing key state jobs and putting patients at risk. On the other hand, when Vermonters are struggling in difficult economic times, high prices are also a barrier to access to health care.

All of these factors mean that this will be a year of very difficult, difficult decisions. I am well aware that any decision the organization makes will have a significant impact on Vermont families, small businesses, and our health care system. I will be leaving knowing that the board members will have made the best decisions, given the choices they have.

In this difficult environment, we must do the best we can with the resources we have and balance our interests, as Vermont law requires. This year’s challenges underscore the need for Vermont to consider sustainable health care for years to come.

The silver lining is that tough times go hand in hand with new ones. For many years, the organization has been talking about hospital sustainability in our annual hospital budget review process, and we are not the only ones. The Legislature recently passed Act 167, tasking the board with other government agencies and stakeholders and service providers to consider sustainable security. We are fortunate to have partners in the public and private sectors as we begin this difficult task.

When I look to the future, I am optimistic. As I see it, our goals are to focus on sustainability, to bridge the gap between access and affordability, and to continue to find ways to ensure that all Vermonters receive the right care at the right time.

It’s not just about how much money we spend on health care. It affects health outcomes and what we get for every dollar spent. This will not be easy, but it is not important.

How Vermonters can get involved

A major pillar of the organization’s mission is to make health care more accessible to Vermonters. Our meetings are open to the public, and the public is always encouraged to attend and provide their written comments.

Upcoming opportunities to join the board are:

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BlueCross BlueShield of Vermont hearing, Monday, July 18, and tentatively Tuesday, July 19, starting at 8 am.

MVP hearings, Wednesday, July 20, and Thursday, July 21, starting at 8 am.

Public comment review, Thursday, July 21, from 4 to 6 p.m

Listening to the budget of hospitals

Weeks of Aug. 15 and Aug. 22, hearing all day Monday, Wednesday and Friday from 8:30 am.

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Tags: Act 167 , Green Mountain Care Board , health insurance , Health Care Budget , Kevin Mullin , rate hike

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