Insurance Coverage Doesn’t Ensure Access to Care
By Consumers for Quality Care, on November 27, 2024
Vermont has one of the lowest uninsured rates in the U.S., yet consumers pay some of the highest health-insurance costs in the country and face barriers to receiving the care they need, according to KFF Health News.
While state and federal policy makers have put an emphasis on expanding health insurance coverage for more consumers, coverage doesn’t always ensure affordable, equitable health care, according to Keith Mueller, a rural health expert at the University of Iowa. “Vermont’s struggles are a wake-up call that insurance is only one piece of the puzzle to ensuring access to care,” said Mueller.
Here’s why Vermonters are facing high health care costs:
- Vermont is one of the least populated states, making it difficult to spread insurance risk.
- As in other states, health workers in Vermont are less inclined to work in rural areas.
- Many residents seek care in New York or Massachusetts, where they can be seen quicker. But those visits incur out-of-network charges, which increase costs for consumers.
- In Vermont, the independent Green Mountain Care Board is supposed to regulate hospital and insurance price increases. But until recently, the board rubberstamped nearly every request for price increases. This practice continued until Vermont’s health care prices became some of the highest in the country.
The state has made several changes to address these issues, including converting rural hospitals to outpatient facilities and consolidating specialty services to control costs while still delivering quality care for consumers.
Having insurance is not enough. CQC urges lawmakers and insurers to find solutions to deliver affordable, accessible health care for Americans and prevent consumers from going into medical debt for seeking the care they need.
