- Associated Press - Friday, March 10, 2017

MONTPELIER, Vt. (AP) - The current version of the Republican-led plan to repeal the Obama-era health care system could cost the state’s Medicaid program up to $200 million in federal funds in 2020 and the number of people without health insurance in the state could increase, the state’s top health care officials said Friday.

But many unknowns remain for the state’s health care system, said the officials who have been monitoring the plan being considered by the U.S. House to replace the existing Affordable Care Act.

“My biggest fear is that this is a tremendous opportunity for the United States and for Vermont to actually fix the problems that we all know that we have with our current health care system and that we will just miss the opportunity,” Vermont Human Services Secretary Al Gobeille said at a briefing for news reporters.

The legislation being considered in Congress that would replace much of former President Barack Obama’s health law was approved by two House committees Thursday.

The legislation, strongly supported by President Donald Trump, would eliminate the unpopular tax penalties for the uninsured under the ACA, replacing it with a plan likely to cover fewer people but - Republicans hope - increase choice.

Gobeille, who chaired the health-care regulating Green Mountain Care Board under former Democratic Gov. Peter Shumlin, said many Vermonters found the existing system unaffordable. They’ve also complained that the computer system set up so people could get coverage never worked well, he said.

Gobeille became secretary after Republican Gov. Phil Scott took office in January. He and the state’s health care team have been working to understand how the congressional proposal would affect Vermont’s health care system.

Vermont Health Access Commissioner Cory Gustafson said that as presented now, the plan being considered in Congress could make it harder for people who are poor or disabled to get Medicaid coverage and the state stands to lose between $190 million and $200 million in federal funding for the program in 2020.

If that comes to pass, it will be up to the state to decide how to cope with the loss in funds, such as reducing the amounts paid to health care providers or reducing benefits. Officials are also concerned it could increase the gap between people eligible for Medicaid and those who can afford insurance, resulting in more people without health coverage.

“We have done a good job of closing that gap. We now have one of the lowest uninsured rates in the country, and looking at this we have concerns this will march us back,” said Mary Kate Mohlman, Vermont director of Health Care Reform.

“There are not a lot of great options,” Gobeille said. “That’s why this is so serious.”

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