New Shumlin Health Care Plan Could Expand Access To Primary Care

Gov. Peter Shumlin says he'll unveil a major health care initiative later this week that's designed to strengthen Vermont's primary care physician network. A second goal of the plan is to lower the cost of private health insurance premiums.

The governor says his decision not to pursue a single-payer health care system this year doesn't mean that he won't propose some key health care reform plans.

One of these plans involves the Medicaid reimbursement rate that's paid to health care providers. In many cases, this rate represents less than 60 percent of the actual cost of the service. In order to make up the difference, these costs are then shifted onto people who have private health insurance policies.

It's estimated that between 15 and 20 percent of private premiums are due to the cost shift caused by Medicaid, Medicare and unpaid medical bills. Shumlin says this system has to be changed.  

"It's absolutely critical that we finally fix our broken payment system where those that are serving Medicaid clients are so badly reimbursed that they either can't stay in business or they won't serve Medicaid clients in the first place," said the governor.  

Shumlin says boosting the Medicaid reimbursement rate will help reduce the cost shift and encourage more physicians to see Medicaid patients.