Achieving Universal Coverage Through Comprehensive Health Reform

In 2006, Vermont passed the Health Care Affordability Acts (HCAA) to create universal access to affordable health care, contain costs and improve the quality of care. Five years after comprehensive health reform legislation, coupled with aggressive outreach strategies and premium subsidies, the percentage of residents with health care coverage has rapidly increased, as has the take-up of Catamount Health, the public insurance program created under the HCAA.

This brief from the State Health Access Reform Evaluation (SHARE) initiative examines these impacts in the context of the Affordable Care Act (ACA), and evaluates the potential implications for national health reform. Lead author Ronald D. Deprez, Ph.D., M.P.H., of the Center for Health Policy, Planning and Research at the University of New England examines several lessons, including:

  • Premium assistance encourages take-up of coverage among lower-income groups—indicating the necessity of ACA exchange subsidies;
  • Outreach and marketing campaigns are effective in encouraging take-up of coverage programs, particularly among those who are eligible, but not enrolled—a particularly salient finding given the large number of people nationally who are eligible but not enrolled in Medicaid/CHIP programs; and
  • States will require additional federal funding as current funding mechanisms, such as those underlying Catamount Health, are unsustainable over the long-term.

As a national leader in state health reform, the policies and practices involved with HCAA implementation in Vermont will be helpful as other states consider implementing either their own health reforms or the reforms specified by the Affordable Care Act.