Health System Reform Insights

GREEN MOUNTAIN CARE

Green Mountain Care

The universal care in Vermant was to be enacted in form of a single-payer system which largely borrowed on a Health System Reform design authored by the consultant. The health system reform design was a proposal by the consultant to provide three design options which are required by Act 128. The main aim of the said act was to create a healthcare system that would focus on wellness and prevention, control medical costs, and give Vermonters equal access to a benefits package that was standard. However, the said form of care had some prospects that made it not succeed in implementation. In 2014, Shumlin, who had been reelected, declared that the universal care was not going to be attained at that time given that it was likely to cause an economic shock that was too high for Vermant. This is more so the case given that there was no financial plan that had been put in place for its adoption. For instance, the green mountain care was going to increase the employer’s taxes by 9.4 and an increase personal state income tax by 3.1%. On the other hand, the political factors which made the Green Mountain care not to be implemented were inclusive of, but they were not limited to; concerns on how the public would respond to a 45% increase in state budget, weak support in the legislature, lack of a clear mandate, and erosion of public and hospital support. Others argued that some people were covered by out-of-state insurers and federal plans and thus the GMC was unlikely to create a true single-payer system.

Like the green mountain care, the Affordable Care Act aimed at improving access to care. For instance, Kominski et al. (2017) suggested that ACA improved access to primary and preventative care. In addition, the ACA was going to control medical costs by improving affordability. However, like the green mountain care, implementation of the ACA faced some challenges related to its expansion. This is more so the case given that not all individuals benefited from the said act. Essentially, the ACA insurance coverage was likely to increase utilization which would then overwhelm state budgets and the healthcare system (Komonski et al., 2017). In addition, the ACA insurance coverage did not provide insurance to all people. For this reason, many people remained uninsured owing to the perceived cost of insurance - given that the said insurance plan required applications in form of tax credits. Further, like the GMC, ACA insurance was not going to cover some people. Specifically, ACA provided cover only for the uninsured, leaving behind individuals who had federal plans (Tolbert et al, 2020).