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Date:  July 31, 1995
For Release:  Immediately
Contact:  HCFA Press Office (202) 690-6145

Through this demonstration, Vermont will make comprehensive health care coverage available to approximately 90,500 individuals, including 64,000 individuals currently eligible for coverage under Vermont's Medicaid program, and 26,500 uninsured poor (with incomes up to 150 percent of the Federal Poverty Level) who will become newly eligible. Vermont will also provide a Medicaid pharmacy benefit to the state's lower-income Medicare beneficiaries, which will require cost-sharing by the beneficiary. The state plans to begin implementation of the demonstration on Jan. 1, 1996.

All current Medicaid beneficiaries will be included in the Health Access Plan, with the exception of those receiving long-term care in institutions or home and community-based settings; those eligible for Medicare; and those eligible for Medicaid because they have very high medical expenses. Medicaid beneficiaries who do not participate in the Vermont Health Access Plan will remain in the state's fee-for-service Medicaid program.

Secretary Shalala stated, "Gov. Howard Dean should be commended for his leadership in developing this plan to expand coverage to uninsured Vermonters. This demonstration is an example of the administration's commitment to providing states the flexibility they need to design health care systems that improve access and quality of care for their citizens."

Bruce C. Vladeck, HCFA administrator, stated, "Vermont's demonstration provides unique features that are not replicated in any other state health care reform demonstration. No other state's demonstration includes a pharmacy benefit for Medicare beneficiaries or such innovative mental health and chemical dependency benefits."

Current Medicaid beneficiaries participating in the demonstration will receive a core set of services through capitated managed care plans, while newly eligible participants will receive a capitated comprehensive managed care package similar to those offered in the private sector. The mental health and chemical dependency benefit will not offer a defined benefit package, but instead will be based solely on an assessment of each individual's medical needs.

Since January 1993, HHS has approved 11 comprehensive health care reform demonstration projects, and 24 targeted Medicaid demonstrations. The administration has also approved 36 welfare demonstrations for 32 States.