Vermont § 1822 - Implementation; waiver

§ 1822. Implementation; waiver

• (a) Green Mountain Care shall be implemented 90 days following the last to occur of: (1) Receipt of a waiver under Section 1332 of the Affordable Care Act pursuant to subsection
  (b) of this section. (2) Enactment of a law establishing the financing for Green Mountain Care. (3) Approval by the Green Mountain Care Board of the initial Green Mountain Care benefit
  package pursuant to 18 V.S.A. § 9375. (4) Enactment of the appropriations for the initial Green Mountain Care benefit package
  proposed by the Green Mountain Care Board pursuant to 18 V.S.A. § 9375. (5) A determination by the Green Mountain Care Board, as the result of a detailed and
  transparent analysis, that each of the following conditions will be met: (A) Each Vermont resident covered by Green Mountain Care will receive benefits with an
  actuarial value of 80 percent or greater. (B) When implemented, Green Mountain Care will not have a negative aggregate impact on
  Vermont’s economy. This determination shall include an analysis of the impact of implementation
  on economic growth. (C) The financing for Green Mountain Care is sustainable. In this analysis, the Board
  shall consider at least a five-year revenue forecast using the consensus process established
  in 32 V.S.A. § 305a, projections of federal and other funds available to support Green Mountain Care,
  and estimated expenses for Green Mountain Care for an equivalent time period. (D) Administrative expenses in Vermont’s health care system for which data are available
  will be reduced below 2011 levels, adjusted for inflation and other factors as necessary
  to reflect the present value of 2011 dollars at the time of the analysis. (E) Cost-containment efforts will result in a reduction in the rate of growth in Vermont’s
  per-capita health care spending without reducing access to necessary care or resulting
  in excessive wait times for services. (F) Health care professionals will be reimbursed at levels sufficient to allow Vermont
  to recruit and retain high-quality health care professionals. (b) As soon as allowed under federal law, the Secretary of Administration shall seek a
  waiver to allow the State to suspend operation of the Vermont Health Benefit Exchange
  and to enable Vermont to receive the appropriate federal fund contribution in lieu
  of the federal premium tax credits, cost-sharing subsidies, and small business tax
  credits provided in the Affordable Care Act. The Secretary may seek a waiver from
  other provisions of the Affordable Care Act as necessary to ensure the operation of
  Green Mountain Care. (c) The Green Mountain Care Board’s analysis prepared pursuant to subdivision (a)(5) of
  this section shall be made available to the General Assembly and the public and shall
  include: (1) a complete fiscal projection of revenues and expenses, as described in subdivision
  (a)(5) of this section, including reserves, if recommended, and other costs in addition
  to the cost of services, over at least a five-year period for a public-private universal
  health care system providing benefits with an actuarial value of 80 percent or greater; (2) the financing plans provided to the General Assembly in January 2013 pursuant to 2011
  Acts and Resolves No. 48, Sec. 9; (3) an analysis of how implementing Green Mountain Care will further the principles of
  health care reform expressed in 18 V.S.A. § 9371 beyond the reforms established through the Blueprint for Health; and (4) a comparison of best practices for reducing health care costs in self-funded plans,
  if available. (Added 2011, No. 48, § 4; amended 2011, No. 171 (Adj. Sess.), § 36a, eff. May 16, 2012.)