 I'm the Chair of the Green Mountain Care Board and I'm going to ask all the board members to introduce themselves in just a minute, but I just wanted to make sure that everybody who wishes to speak has had a chance to sign in and Abigail or Christina will bring me the sheets and I'll call your name, but I'll also call the person's name who is on deck so that you can be ready and what we're asking so that we can get a truly good public record of everyone's comments. If you could step up to that mic over here to my right to your left and speak into that when you're doing it, that way it'll be recorded for posterity purposes and we'll make sure that we get everybody's comments as part of the permanent record. So what we're all here today to talk about is two rate filings in the QHP plans which is the exchange and we know that this is not an easy year. These are some pretty high rates and I know that there are going to be some pretty, I shouldn't say heated opinions, but some very strong opinions. So just keep in mind that Vermont has a great record of doing everything very civil and we're not the enemy, we're here to try to get to affordable rates in Vermont. So if you could just come up and really speak from your heart and tell us what you want us to know about the QHP filings and I think if we do it respectfully we'll have a great night and hopefully we'll learn a lot from each other. So again I'm going to call Alicia Moyer to be the first speaker and on deck is going to be Ethan Park. Yes, so Susan if you could start. Hi I'm Tom Pelham, I'm a native of Arlington, Vermont, I now live in Berlin and I've been on the board for about a year and a half. Hi I'm Robin Lange, I'm also a board member, I've been on the board about three years and I grew up in Brattleboro. I'm Kevin Mullin, I grew up in Rutland. I'm Mike Barber, I'm the board's attorney. I'm Maureen Youssefer and I live in Colchester. Okay Alicia, welcome and thank you for being first. Is there any way that we can get that louder? Hello, there we go. Hello, try that again. My name is Alicia Moyer and I'm getting taller. I meet with people daily as a certified healthcare navigator. I'm certified through Vermont Health Connect and I see a lot of people struggling to make ends meet. I see people who have been on Medicaid for a period of time and because they've been working so hard or their job has improved, they get kicked off Medicaid and then are in the position of selecting a plan. There are so many great plans to select but often the premiums are high and the deductibles are very high. I wanted to describe one of the most compelling examples which is of a couple who started a business a few years ago. They have three children and the business is doing so well that this year the children became ineligible for Dr. Dinosaur and they were in the position of selecting a plan through Vermont Health Connect through the exchange. They selected the bronze plan which is the least expensive so they now have a $1,200 premium for a family of five and they as I spoke with them they described just being in the position of choosing between their mortgage payment and their health care premium so I just wanted to describe that as really the you know it's a hard-working family successful business they have actually I should have mentioned they have eight employees including including themselves and they really take seriously putting their employees first making sure they're paid and I would just hate to see such high rate hikes for a family like that as an example so I guess that'll leave it at that. Thank you. Thank you Alicia and I know that at some point I'm going to really badly butcher somebody's name please excuse me but next is Ethan Park and on deck is Jeanette Hogue I hope. Welcome Ethan. Thank you. I'm Ethan Park from Montpelier Citizen. Consumer reports list the ACA health insurance costs in all 50 states for 2019 citing insurer rate filings and other sources for comparison the report just chose one plan which is the lowest or second lowest cost silver plan for a 40 year old male who doesn't receive financial subsidies and Vermont's example was an HMO plan with a $622 monthly premium $1,550 annual deductible out-of-pocket maximum $6,650 total exposure including premiums up to $14,111 the increase for this example from 2018 was 23.2 percent the highest increase in the US in this consumer report comparison not only was Vermont the highest but Vermont and North Dakota were by far the outliers the other states were far below including Tennessee that decreased a hefty 26.2 percent from 2018 now I understand that the Blue Cross and MVP filings are an average of increases on a number of plans but I have to wonder that consumer reports chose this one plan as some kind of an indicator so that consumers could tell how affordable health insurance was in the various states another study by United Benefits Advisors found Vermont to have the fourth highest premiums in the US for an individual in 2016 and although our average annual deductible was a little bit lower and somewhat offset these higher rates we still ranked in the lower half of states in terms of affordability in 2013 here in Vermont we started spending the 45 million dollar federal SIM grant more federal money was poured into setting up the ACOs and the advent of one care was heralded as something that would control costs and improve quality neither has occurred we are now in year two of the all-payer model excuse me for my tremor and I don't think very many people can understand what the all- payer model is and I haven't heard a good explanation for it we the public just doesn't know what the heck it is I recently heard about a state employee went to the Waterbury urgent care clinic for an attached tick the tick was easily removed and the employee was given 200 milligrams of doxycycline the charge was $1300 and my view of the changes that the care board is ushered in with the ACO and so forth is only feeding the monster the hospital expansion projects the many new consultants overpaid administrators and contractors the new IT systems one care these changes have resulted in rapid consolidation and monopolization on the provider side which hasn't turned led to less insurer bargaining power and higher charges the care board should limit hospital prices to the consumer price index as Rhode Island has done or index hospital prices to Medicare as proposed in North Carolina or hold hospitals to a global budget as Maryland has done the care board should also examine why there are huge variations between hospitals and what commercial insurers pay for the exact same services we are in danger of losing rural hospitals we are losing primary care providers in some locations independent practices of all but vanished there's been a decrease in primary care visits among Medicaid recipients in the ACO there's been a noticeable deterioration in the quality of primary care as clinicians hurry patients in and out stare at the computer which is all about coding and billing and practice to the so-called test the reason for our high commercial insurance rates is not the aging population or the cost shift these are red herrings that are easily debunked I would like to leave you an article published yesterday in JAMA that pins the blame for high commercial rates on insurer secrecy and big hospital greed we have a medical industrial complex that is out of control and will not restrain itself despite the rhetoric of accountability the only restraints we have rate review CON and hospital budget reviews are proving inadequate the care board needs to get tough and creative thank you thank you Ethan Christina could you could you raise your hand over here right behind Ethan is Christina McLaughlin from our staff and Ethan the comments that you wanted to enter into the record if you could give them to Christina show make sure that they get properly entered and if anybody else has any written comments they wish to have entered into the record if you could likewise after your comments are made give them to Christina and we'll make sure that they're a permanent part of the record so Jeanette Hogue and on deck Christine Smith and please make corrections where I butcher names you did good and I'm here on behalf of my partner he has worked and paid taxes for over 50 years he has COPD and emphysema from working in the gasoline industry going inside gas tanks with toxic fumes wearing only a paper mask it's just slowly going back 50 years he has COPD and emphysema from working in the gasoline industry going inside gas tanks with toxic fumes maybe if you could face them maybe turn the mic so that you could face them and then is this better just pretend like you're Robin Williams in Good Morning Vietnam and belt it out okay can you hear me now okay he has COPD and emphysema from working in the gasoline industry going inside gas tanks with toxic fumes wearing only a paper mask a job that now requires people to wear a mask and outside airlines he gets $1500 a month disability and Medicare which only pays for 80% of his medical bills once he pays his monthly expenses there is no money left over to pay for supplemental health insurance to cover that extra 20% yet he does not qualify for Medicaid he applied for financial assistance with his regular doctors and hospitals when he checks in with the receptionist she says oh you have Medicare and you're a welfare patient talk about being shamed for being disabled while other medical providers do not offer financial assistance currently he needs supplies for his oxygen machine and his CPAP machine and he cannot get them because he has a pending bill for the company that supplies these items he has to pick and choose which providers he can send 10 or 20 dollars a month towards his balance so the other providers send his bills to collection agencies Vermont needs a universal health care system that fully meets the health care needs of all the people and is equality financed your system is not working if you raise your rates you will just hinder more people from accessing health insurance and some people meet some people may even have to drop their coverage because they can't afford the premium thank you thank you so up next is Christine Smith and then Elizabeth Clark good to see you again first time I was can you hear me all right Verizon's working so as you can tell half of the room is for from Vermont worker center wonder why we all want universal health care we have been fighting for it it's done past and what do we get blue cross blue shield once another 15% increase wow isn't that a miracle what happens to the people that have to pay $1500 a month just to get insurance but where does that money go does it go to the insurance does it go to the doctors where's it go I don't know maybe the CEO's pocket where it don't belong for me I still take care of my mother my mother's got dementia it's now moderate to severe I have two brothers who don't give a care I'm the youngest out of three I do all the hard work at home I have to change my mother I have to make sure her food is done I have to do her laundry I have to clean house does anybody know what it's like anybody does anybody take care of their parents do you take care of your parents so you know what I'm talking about do you they're both dead but as they were dying I did and do you but you took care of her and it's very hard is it not did you have family to help you with it so you know I have two brothers and God can strike me they don't give a damn I talked to one of them last night and all he was worried about was him getting into an accident and not being here it's very hard very hard so all these increases that everybody wants in these insurance companies really don't need them if you ask me they all can go to hell where the richest country in in the United States or whatever and all the other countries have universal health care but what we don't it's not fair it's not fair so something needs to be done literally thank you thank you Christine next is Elizabeth Clark and on deck is Graham from rural Vermont and Graham I'm not going to even attempt to say your last name because I know I would butcher it so I'm gonna let you introduce yourself when it's your turn so Elizabeth hello my name is Elizabeth Clark I am a green mountain care now but before I was on Blue Cross Blue Shield from 94 until a few years ago when I was working I could afford to buy private insurance but when I lost my job I couldn't afford to pay for it anymore luckily I qualified for a Medicaid and that's what I am on now since I'm just able I couldn't work if I didn't qualify I would never be able to afford private insurance I can't afford it now I definitely wouldn't be able to afford private insurance if it was another 15% we have to live on Goodwill food for half of the month as it is because we only get $194 and food stamps and that only covers half of the month for us food is not cheap nowadays so I'm here today to tell you that we need accessible health care for all people because none of us should have to go without thank you Elizabeth so next is Graham and after that is Madeline Walker and Graham if you could just start by introducing yourself and now then I'll know how to say your last name too no that's that's fair enough my name is Graham Union angstrufnacht I'm a small farmer and I work at a I can't I've been doing this my whole life it's UNANGST-RUFENACHT so I work at rural Vermont a local nonprofit that works on small farm advocacy food sovereignty I said I'm also a small farm in the area I grew up in East Montpelier Vermont live in Plainfield Vermont there's been a general call from farmers nationally and locally to advocate for them in health care processes we put out an issue survey last fall to over 200 people who've been at this survey and surprisingly they all ranked health care as the issue at the top of the list affecting them their families their farms the issue they were most concerned about a national survey put up I hired an AG in 2017 which Shoshana Inwood formerly of UVM was an architect clearly showed that farmers want the USDA to advocate for them on behalf of their health care needs Rovermont feels these proposed rate hikes and ongoing rate hikes to this degree on a yearly basis are affordable excessive and inequitable here are some of the statistics from the 2017 hired an AG national farmer rancher farmer and rancher survey health insurance is a national farm policy issue health insurance is tied to farm and ranch risk management farm viability and economic development over half of the households which is 55% and the study are not at all or slightly confident they could pay for the costs of a major illness or injury without going into debt 22% of the farm households at a medical or dental debt of over $1,000 over three fourths 79% these households that health insurance was a risk management tool for their business 72% want the USDA to represent them in national health insurance policy discussions which I already mentioned almost half of farmers and ranchers 45% are concerned that they will have to sell some or all of their farm or ranch assets to address health related costs such as long-term care nursing home or in-home health assistance just over half of farmers and ranchers 52% are not confident they could pay the costs of a major illness such as a heart attack cancer or loss of limb without going into debt farmers are particularly vulnerable to health care needs given the average age is close to 60 years old their type of work is physically demanding if they are injured they rarely have people who they can bring on and there's no paid leave to cover them or their small businesses the USDA general average national income projected for 2019 is negative 1449 dollars negative 1449 dollars Vermont farm to plate some numbers I thought was interesting from a 2015 report of theirs that 79% of farms under 220 acres almost 5 4500 farms got less than 25% of their household income from farming 67% of farms over 260 acres which is 893 farm farms which is now dropped substantially got greater than 25% of the household income from farming what I think is notable about that is that the the marker here is 25% of your household income from your primary form of livelihood the general trends in farm income and rural economic health need to be justly considered in your deliberations concerning the affordability and access of health care in Vermont how will rate hikes affect farmers and those they connect with we have water quality issues in Vermont right now and in the farm and water coalition and other groups we know that environmental wellness is directly tied to farm viability and we know that health care is directly related to farm viability we know the farm viability itself is compromised we know that mental health it's challenged on farms farmers are getting milk checks in the mail right now and with many of those milk checks they're getting suicide prevention notices we know that this will result in worse health care outcomes if they can't afford health care and we absolutely know that farmers cannot afford rate hikes which have absolutely no corollary in their livelihood or field in terms of the equability of these proposed rate hikes I'll get back to them in a moment the proposed rate hike will without a doubt affect the affordability of health care for many Vermonters who are currently struggling to afford the cost of the current health care the effects of this will ripple out socially and economically and lead to worse physical and mental health outcomes throughout our communities this morning a representative of Blue Cross Blue Shield said that we are quote-unquote on our way to a more sustainable health care system through this process this is certainly not true for a public which which is currently being asked to afford some of the most expensive health care globally with some of the poorest health care outcomes we know that publicly funded universal health care is the only sustainable path forward and the only path that assures consumer protection and health care is a human right this morning the person from Blue Cross Blue Shield said that the solvency for this in it for his industry and company is the most fundamental factor in consumer protection he said the individual Vermonters may struggle to afford health care but better to struggle than to lose access and I think these comments really show how to touch this is with most Vermonters lives I think the most Vermonters would feel relatively repulsed by these sentiments and understand that if we do we do lose access when health care is not affordable affordability is access he said that it's so expensive because they must they must provide rates on a community versus individual basis in Vermont and I think all of us here today know that our community members all of them are struggling to afford their premiums or almost all of them their deductibles and insurance regardless of their age he said that because there is quote-unquote no penalty for not carrying health care in Vermont they may lose people this coming year and they're planning on that and their proposed rate hikes we suggest that they will lose people not because they off they will they will lose people because they offer unaffordable and inadequate coverage most fees suggested over time for not purchasing health care are less expensive than the excessive costs of health care itself as Blue Cross Blue Shield has pointed out there are many rising costs in the health care industry from pharmaceuticals to hospital executive salaries which affect their rate projections we recognize these factors and agree that they are problematic and absolutely must be addressed and we feel it's unjust and inequitable to pass along the cost of these problems to the rate paying public when most of this industry the health care industry and its players enjoy profits and salaries well above that of most Vermonters lastly we recommend that this board suspend the end date of this public comment period and conducts public hearings like this across the regions of Vermont outside of normal working hours this hearing in process itself is relatively inaccessible for those who need to work regular hours or travel in order to have their voices heard in person I will submit this testimony tomorrow potentially slightly expanded thank you for your time thank you Graham so next up is Madeline Walker and on deck is pie sigh Laura tell I believe can everyone hear me alright my name is Madeline Walker I am from the White River Junction area and I just wanted to briefly share with you all what it's like to actually be someone with a chronic illness who's struggling with health insurance I am 20 year old I have been chronically ill since I was 18 I have an illness that displays itself in chronic pain muscle weakness and nausea so this is something that affects my everyday life at the onset of this illness I was seeing multiple doctors a week I was having multiple surgeries scans procedures and I slowly stopped because even with my health insurance blue cross blue shield at the time it was practically unaffordable now I am uninsured looking trying to get on a plan that is not only affordable for me a 20 year old with nothing but a high school education and covers the treatments I need to function on a daily basis and it's reached the point where it's a vicious cycle I need certain treatments to go to work and I need to work to afford those treatments I think about health care and my health insurance every single day it's not something I think about when I go to the doctor's office or when I have to pick up a prescription this is something I carry with me every single day the ability to afford the care I need to function to give back to my community to engage with this beautiful state we live in and I just I need you to know that accessible and affordable care is care that someone doesn't have to wake up and wonder if today is the day that they go broke because they have to see their doctor we need affordable and accessible healthcare in Vermont and these rate hikes aren't it thank you thank you Madeline um before we go to the next person I I see Eric here I'm not sure if Mike is here but is Mike there with you could could you just stay could perfect raise your hand which is what I wanted Madeline if if you could talk with Mike in the back or Eric there they might be able to help you to try to figure out how you might be able to get access to care they're from the Vermont Health Care Advocates Office and they work on it on a daily basis trying to make sure that Vermonters have access to care so is somebody's car horn going off okay so um and I I'm sure I butchered this one completely Pisci Laratro and then Kevin Wagner maybe it's pre see I'm sure I butchered it badly any ideas well if I don't call your name by the end of this list then um please raise your hand and we'll make sure that uh we hear you because we don't want anybody to uh not have the opportunity so next is Kevin Wagner and on deck will be Keith Batlick hi uh my name is Kevin Wagner I'm from Bradford Vermont and I'm on MVP Health Care um I I testified here last year and I'm probably still paying down medical debt from doctor's visits I incurred around that time I'm being treated for hypertension and and it definitely affects the amount of care I'm able to seek out that you know like every time every time I go to the doctor it's going to be yet more debt and I've I've told this story before and everyone a lot of people here have stories just like it and you know I have to admit to feeling very frustrated that like we keep we we keep having to come tell these stories year after year not not not just to this board but to legislative committees and and and and other forums and we basically have to plead for our lives and and you know I'm trying to assume best intentions in all of your parts um but yeah like the end the end result is the same that like people just shrug their shoulders and say well you know like I we'd like to help you but I guess there's nothing we can do about it but you know it's like I've been paying attention to this issue long enough that I can remember when when Vermont Health Connect was presented as a temporary stepping stone on the path to true universal health care and you know and and no progress seems to be being made on that front and and like every year greater rate hikes get proposed and you all end up approving maybe it may be a lesser number than was originally proposed but you know the amount we're having to pay for care keeps going up and but I certainly haven't gotten a 10 a 10% pay increase over the past year and and I'm sure most of the other people in this room haven't and it's it's it's not fair we need we we need real solutions and we need them now thank you thank you so next is Keith Batlick and on deck is Ellen Schwartz and Susan if you could collect the next sheet from Abigail okay I'd like to ask if I could switch with someone who has to leave and she'd really like to speak well absolutely okay Rachel and Rachel what's your last name my name is Rachel Nelson and thank you for the special treatment today um I can my name is Rachel Nelson and my husband and I live in Barry Vermont where are some of the lucky ones with gainful employment who are doing well I'm going to cry I may or may not have an anxiety attack I may vomit uh you see some of you may have noticed I appear to be pregnant and it's because last week I was I'm struggling with morning sickness and one of those things I don't tell you growing up with the idea of having children is that morning sickness doesn't go away when your baby dies you get to keep that for a while they also don't tell you that you will have to argue with your insurance company that you still deserved your medical care even though your baby died this is something that makes me feel quite insane right about now because I have all the pregnancy hormones and the postpartum hormones and not a baby to halt and it's my third time in a year and each time the doctor said it was a fluke so they didn't run tests because the insurance doesn't want to pay for tests to find out why my babies keep dying as we enter the second trimester and things are supposed to be wonderful and what what our insurance does we see we are on blue cross blue shield of vermont is they cover pregnancies you don't have to pay copays there are certain fees along with the monthly amount that you have to pay unless your baby dies then it's not pregnancy it's not prenatal care then you have to have a dnc an abortion to remove your dead baby from your body because your body is fighting to hang onto that baby and it sucks it's super duper sucks and your insurance says it wasn't a necessary procedure except if you leave a dead baby inside of your body you'd die it was a necessary procedure that I had to argue with them for over a month what felt like arguing for my soul a year ago in June but doctors said it would be okay so we did it again we were supposed to have a little baby for Christmas and it didn't happen we were supposed to have a little baby this July and it didn't happen and we're supposed to have one in January and it didn't happen and you know what sometimes life sucks and that happens but I'd love for someone to explain to me why I have to argue with an insurance company and why instead of healing right now and lying in bed and trying to face this which I haven't done yet I haven't said these words out loud because I've been pregnant 42 weeks and I'm not going to hold the baby and now now that I give up they'll run the tests now the insurance is okay with that I'm not I don't know that I could ever do this again but the doctors will the insurance will my babies my older children are home sad they were expecting a little brother in January and a little sister in July and we don't even know about the first baby I should never have to argue that I was pregnant I should never have to argue that I deserve as much coverage and as low fees as a woman who gets to hold her baby at the end of this that's not okay no woman should have to argue these details out with an insurance company as her heart sinks further into her chest the last time the woman at the hospital couldn't even take it and she got tired of the arguments and she hated it herself and she decided to write off those charges that I felt like I shouldn't have to pay and I'm so glad for her but no other woman who doesn't have the strength to come in here to say this no person should have to fight why their illness why their problem why their pain is not something that they should have to argue with somebody who also wishes that we just covered it it's medical care it's needed shouldn't have to argue that while your life is falling apart why everything sucks thank you thank you Rachel so Ellen Schwartz and then Erica Dodge it's really hard to I'm Ellen Schwartz from Brattleboro it's really hard to speak after that hearing that story but I will I'm sharing this comment on behalf of my grandson Nicholas Algren who couldn't be here tonight because he's working Nick graduated from Keen State this spring and in spite of earning a BA he's currently working for $11 an hour up until now he was on Dr. Dinosaur when he was a child and then adult Medicaid both of which provided him with the care that he needed he's now reporting his new income to Medicaid and he anticipates being informed that he no longer qualifies he met with Alicia or spoke with Alicia the healthcare navigator to learn about his options on Vermont Health Connect and fortunately he will call he will qualify for a subsidy however I was talking with him after I got home from after he had this conversation my understanding is that the plan that he'll get will not include dental or vision and will come with deductibles so the combination of the premium which is what we're talking about tonight but for the person there's also the deductibles and all the things that he's no longer qualifying for like the vision and dental that he has to save money to pay for out of pocket for him it's like all one expense it's not just the those things aren't separated out and all of that is going to be steep for a person who's earning he's working full-time earning $11 an hour and also needs to start payments on over $40,000 of student debt and keep a car running in a short so he can actually get to his job and earn that $11 an hour the premium increases are just one element of a fragmented and dysfunctional health care system it makes no sense that nick and other people like him are worse off because they're working than they were as children or students who qualified for Medicaid we should all have access to what Medicaid offers it shouldn't be based on whether you qualify or whether you don't qualify $11 an hour is a low wage but at full-time apparently it's too high for Medicaid so he's actually in a worse position because he took this job denying the rate hike requests won't fix the broken system but it will rein in the cost to people who are already on the edge financially because the system is so fragmented the rate hike requests are divorced from the reality of people's lives where insurance premiums are just one of the costs of health care and one of the costs of living ultimately what we need is one system for all of us so that people don't have to jump through hoops in order to get health care or deal with denials like we've heard about tonight or worry about what they're going to do if they are denied that is the unfulfilled promise of Act 48 and I look forward to the day when we don't have to come to these hearings anymore because we have a truly universal system where Nick and thousands of other people in Vermont can rest easy knowing that we all have access to the health care that we need please deny these rate requests and do everything within your power to move us to a system that provides health care for everybody thank you thank you Ellen next is Erica Dodge and on deck is Keith batlik hello I came here today as a small business owner a mother and a wife my husband and I recently chose to settle in Vermont we're originally New Hampshire natives I am a self-employed architect my husband a self-employed builder we live in Morristown and we love our quality of life we're so lucky to have jobs and live in the beautiful mountains the rising costs of living in Vermont are not reflected by the wages we make we are faced with daycare health care our mortgage it's just the the cost of living on their eyes cannot be sustained here we're faced with a difficult decision of did we make the right decision of living in Vermont we've lived in highly taxed states we lived in Maine California and we ultimately chose here to settle we're contemplating whether or not we need to move back to New Hampshire to live closer to family so they can assist with the cost of living we're very fortunate people to have the support of family we're in a position where we could potentially provide good jobs to our community but we're not going to be able to do that if we can't afford to live here ourselves so I hope that you consider young families like mine who are faced with these high health care costs my one-year-old daughter had a 105.5 fever three weeks ago and on the back of my mind I didn't want to take her to the emergency room because I didn't want to be faced with a multiple thousand dollar bill I wasn't even sure how much it would be and I shouldn't have to make those decisions I should be able to provide my daughter with the best care possible and know that we'll be able to make our mortgage payment so I ask you consider young business owners and families like myself thank you thank you so next is Keith Batlick and on deck is Kelly Cummings hi my name is Keith Balick I live in Sheffield I've been at this for so long like many people as far as health care reform goes this has been going on for quite a long time over a decade or and beyond every time it seems like we get close to some type of reform which happened in 2011 the plug by 2014 the plug was pulled and here we are back again the more this happens the worse it's going to get it's like a downward spiral is what this is the more people can't afford it the more are going to be dropped out of the system it's going to get more expensive and it's just going to get worse and my question is as far as people paying a good sum of money to be insured and then they have to bargain or try to wheel and deal with the insurance company to get any type of coverage I'd like to know you're looking you're supposedly as far as accountability goes these companies you're overseeing what's going on I'm sure behind the scenes but I'd like to know how often does it happen where an insurance company there's bonuses given out if you can deny somebody coverage and another good question what's the CEO making I mean if there's incentives to deny people coverage there's something's not right here the bottom line it seems to be the dollar and it's a long is this is going to keep going on it's only going to get worse this isn't sustainable and I hate to see that we're going to be back here next year in a couple years and it's only going to be worse and I really hope you hope you hold these companies accountable and I don't know do you get to look at their books or anything yes we do okay is that still going on where they get incentives to deny people coverage bonuses it's not incentives to deny coverage no okay there's in the past I know that's happened in other companies but I'm just curious it just seems like that happens anyway I hope in a couple years people aren't back here again and I hope you'll deny these ridiculous increases and thank you for letting me speak thank you so next is Kelly Cummings and on deck is Bill Coleman I sure wish I'll have this stand working because I've got to turn pages here and I have a small prop um but before I go into my little thing I wrote down which I just want to I want to tell everybody who's here thank you again for coming I know you've been here before I've been here before we've been hitting this for a very long time thank you for telling your stories they're important and I'm sorry that you have them to tell I'm very moved I'm very moved and for y'all I hope I don't know you I don't know you but I hope that this is more than just a job to you I hope that you hear their stories and I hope that you really listen because what they're saying is real and it's their lives it's all their lives and so I hope I hope it's not just okay next next next that's what I hope okay I get really nervous at this and every time I continue to speak up because of these people because this is important um but I'm doing it so when I get shaky and a little goofy just bear with me I know you're with me here so I've decided to take a little different track um I'm going to start with this so I've I've got something to sell you and I've already got the sales contract written up let's just pretend this is it we got it right here so on it we've got a dollar sign we've got a question mark and an x for your signature so there's a no need to read it first because there's nothing there to read but I'm going to need your signatures before you see what you're paying for so how many of you would feel comfortable signing signing this contract I mean anybody if you're a taker let me know let me know right here raise your hand any so so we don't we don't want to do that either we don't want to do that you're exactly right so I can't think of any other consumer transaction in America other than health insurance where we legally commit ourselves to a purchase before we know what we're paying for and how much it's going to cost us we've heard all the talk about shopping around and comparing prices as if we're buying a tv um that's a myth and everyone in this room knows it's a myth we also know why the insurance companies tell us they cannot provide a price list because they've cut a million different deals with a million different hospitals and doctors offices they have intentionally created such a convoluted system for nothing more than to enhance their profits and one example of this is surprise billing we so you know it's where you go to a hospital that you know is in your network and perhaps to have surgery um just to find out when your bill arrives unbeknownst to you you have interacted with all these doctors who are out of network and you're left on the hook because you signed remember that contract that is legally binding you're on the hook for it you signed so this is absolutely ludicrous it's ludicrous we don't do this with any other purchase in america at all no way i wouldn't buy a car and they go here just sign the contract put it right here on the dotted line and then we're going to tell you what you're going to get and how much it's going to cost but when it comes to health care that's it that's our only option that's what we have to do all of us from the there's from the highest to the lowest that's our option it's crazy it's crazy so the you know the the private free market um works for many things right we would agree it works for a lot of things but it is brutally obvious it does not work when it comes to health care it does not work so we have we have no more money to give we have no more money to give and i'm asking you decline these rights we don't have anything more to give so please as john steward so eloquently said please do your job and protect vermonters from the insatiable appetite of the insurance companies who have us on their hook and we are tired of being dinner thank you thank you next is bill colman and on deck as john king thank you yes and bill colman north vermont i'm here to discuss the implications of rate hikes particularly obviously the affordable care act is under fire from corporate interests and being mischaracterized by the corporate media political candidates who attempt to defend the continuation of the affordable care act are really being mistreated brutally just clever choices of words descriptions the way that things are phrased and described influences the public responses and in this way influences the outcomes of elections but um when it comes down to it there are billions and billions of dollars being made off of health care is this um a natural situation that there would be like tens and hundreds of billions of dollars being made off of health care pharmaceuticals and the close alliances and interlocking boards of directors from all these companies or is this just something that some being permitted to take place because of corporate dominance of government that's already been taking place for a long time i contend that this is a very unnatural situation and that the rate hikes being requested at this point by blue cross blue shield are in effort to really drive a wedge between middle income wage earners and those who are currently receiving medicare people receiving green mountain care and things of that nature they know that they can really fuel resentments the higher the rates go the more the middle income workers were forced to pay these very high rates are going to resent the heck out of people who are low income people receiving medicare for free so do they really not have an intense intensely obvious conflict of interest um in any information that they provide and how closely is this information really able to be scrutinized they come up with it they bring it forward to the board and their word is probably taken to be um fairly honest and accurate um we've got a federal government that's believes that industries are pretty much capable of self-regulating so the problems come from the top down we've got 80 000 toxins that have been permitted onto the market by um by manufacturers of all sorts of petrochemicals and um herbicides pesticides and things of this nature and they're right at the root of cancer that people are getting cancer problems end up in the health care system and we're ending up with people who are so it's an unregulated chemical industry that's polluting the air polluting the water ending up polluting people's bodies then they end up in our health care system having to pay you know if they're randomly become a victim of um PCBs or um PFOAs or um glyphosate poisoning they're here in the health care system because the system wasn't regulated previously by the um Department of Agriculture the FDA or whatever regulatory bodies there were but at this at your decision making level when it comes to the insurance we really have to think about this deliberate likelihood of the conflict of interest of this driving a wedge between the middle income workers and those receiving the benefits of green mountain care can we permit it to just go higher and higher is this really anything resembling an ethical system that would normalize the idea of profits being made at this level and a class of people who can just live such extravagant lifestyles while there is such an increasingly bad level of suffering taking place on the part of an increasingly large population that the wealthy people in this country never see the the populations of wealthy people live in economically segregated communities sometimes they're in gated communities around this country they have little or no contact with people of low income who are suffering the most under this system they go to country clubs they know other country club members or um they the places that where they go the restaurants they go to are places where economic elites are congregating but we have an increasingly suffering population that aren't able to even articulate for themselves the extent of their suffering and so because of profits being permitted to take place in an unregulated economic system in a really grotesque manner so it's time to really put a stop to this game that's being played and to severely question the credibility of any request for further rate hikes from this for-profit health care system beyond that we need to really think about what the implications are if this is going to continue to go on in a runaway fashion is this not going to destabilize the entire country at the rate it's going with economic inequality to people's deteriorating health and we know that the population is for the first time dying at a younger and younger age for years longevity had been increasing in this country that's no longer the case people are dying now at younger ages and it's very likely to continue without some sort of checks and accountability being brought to the corporations that are increasingly dominating the government and manipulating the outcomes of every conceivable decision-making board that could possibly exist to try and put the brakes on to the greed and the corruption that is permeating the entire system thank you bill next is john king and on deck is polish ram is john king here okay then we'll go to polish ram and on deck will be walter carpenter i'm polish ram i'm from enosburg falls i'm here to read a letter from my friend caroline bronze also from enosburg who wasn't able to be here she's writing on behalf of her sister who is she wrote this up for her sister her sister's currently involved in the midst of something she's recovering from surgery so caroline wrote about her case i'm writing on behalf of my sister who is recovering from a serious surgery she is a respiratory therapist at a local hospital and has a bcbs gold plan here is her story i saw a doctor on april 30th for unexplained abdominal pain he ordered a ct scan with and without contrast which needed a blood draw to check for kidney function the ct scan was scheduled but was denied as not medically necessary on may 10th the doc had to have a face-to-face talk with the company that blue cross blue shield has hired as a watchdog a i am specialty health the doc told me it was difficult to get this done as they were not available to him when he called but it eventually was allowed and i had the ct scan done on june 4th i had to have a repeat blood draw for the kidney function before the scan the scan revealed a something mass or lesion on my rib and my doc ordered the mri and tried to get me in to see the cardiothoracic surgeon the surgeon wanted the mri done before he saw me on june 14th i received the first denial from blue cross blue shield for the mri the reason the doc couldn't identify it as cancer however of course it couldn't be identified as cancer until the mri was done quite a catch 22 we kept trying to get the scan approved it was a frustrating series of many phone calls paperwork mistakes made by the blue cross blue shield reps papers miss filed lost then the mri was denied a second time on june 21st i called blue cross blue shield on the june 25th to file a grievance and talked to my personnel department on june 28th my personal personnel department emailed them and we were both stonewalled so carolin continues finally my sister's peace private pc physician went out of the box and contacted the surgeon and showed the ct scan to him the surgeon stepped in to require an immediate mri to be done and the next day she had it reviewing the scan the surgeon scheduled surgery as soon as possible which happened wednesday on july 17th remember this all started in april we are waiting for biopsy results and next steps for this rare condition with uncertain prognosis if the scan had been done in april as it should have been if blue cross blue shield had approved the doctor's order in a timely fashion rather than stonewalling obstruct and obstructing we don't know what the outcome of the situation will be but it is outrageous that she had to wait to spend hours fighting and advocating along with others on her medical team only to be blocked time and again we vehemently oppose a rake height hike for this insurance company until they undergo a thorough review of exactly what is their mission what is their protocol for working with the medical professionals who know what their patients need why are they hiring another company as a watchdog why do they deny a scan that not only could save a life but also save money by being done in time so that a condition does not get worse by waiting and carillon ends by saying this system is broken do not put more money into it without an overhaul thank you paul and please pass on our thanks to carillon as well walter and on deck is caron saunders testing i'll try to be brief which is probably refreshing for the board members who know me who are cursed to know me but one of the i had a testimony all written but i'm going to discard that because i've been listening to the hearings and the common theme here seems to be the timelessness the first time i went to a public hearing was in 2009 after i had had to bargain for the price of my own life the insurance company was not blue cross blue shield the ceo of that insurance company made 13 million dollars that year now would probably would be 50 million 60 million for one ceo the ceo's of blue cross and mvp are all in the six and seven figure salaries they have lavish benefits they have nice retirements if i remember right one was sent off into retirement with seven point two five million dollars we subsidize these companies to the tune of millions of dollars every month premiums taxes medicare advantage plans all the rest of them we're being double taxed too because we pay the state taxes for blue cross blue shield because they are not paying state taxes because they are a non-profit i do not know if that's true for mvp but i'm certain that is probably the same or a similar story we also pay for the lobbying efforts that they use at the state house in to keep single payer at bay and to keep health care costs very high i think it's time to think about that and to think about the ultimate question is is whether or not we really need these insurance companies to do something that we could do ourselves just as easily we already do it because over 50 percent of our population is unsure either medicare medicare va or some form of public health insurance so why do we need the other 50 percent of that they consume a vast amount of our health care resources and a rate like this a rate increase like this is pretty outlandish although typical i remember last year we were at hearing what was it ten point something or other and next year we're going to be here again the excuses will be the same you know pharma costs are higher our reserves are low we need to supplement our reserves the actuaries say that our costs are too the patients need more health care than we thought you know on and on and on a year after that we're going to be for another rate hearing a year after that i've been at these hearings for 10 years i'll probably be at them for another 10 years the question that's laying underneath all of this is do we really need these companies the answer is no we could do it ourselves just as easily we don't need to pay millions of dollars every month to subsidize ceo salaries and to subsidize taxes that we pay for in addition to premiums deductibles co-pays and all the rest of it the last raise i got was 50 cents an hour i'm 63 i work in vermont's tourist business which brought in 2.8 billion last year and paid 3.90 million in state taxes the last raise i got was 50 cents an hour and that was begrudging out of that i have to subsidize 11 for mvp and 15 for blue cross blue shield whether i'm an insured person or not every vermont are all 630 000 of us are paying for these two companies in some way or another and it's time to assess what we are paying for we're going to hear these stories again next year and the year after that because that's what we're getting for all that money that we're subsidizing them by thank you very much for holding the hearing thank you Walter so next up is Karen Saunders and on deck is Amy Lester hi i'm Karen Saunders i live in Brattleboro i spent many years as a teacher and when you're a teacher you have this huge extended family and it's their story that i'm here to tell you about you know the 10 and 11 year olds that i spent a lot of years with generally had good health care because we have doctor dinosaur hearing vermont right and that was great but often their parents didn't have good health care and all of you adults in the room know that you worry about your kids what you might not know is that your kids worry about you and when your kids worry about you they're not learning very well funny thing what anxiety does so i would call parents and say what's up your child's having a hard time all of a sudden oh well i've been really sick i can't afford to go to the doctor and i know she's worrying about me or i know he's worrying about me or more than once and at parent teacher conferences i would hear this the insurance rate hikes we had to drop our health insurance and now i can't keep going to the doctor so i recently read that in the last five years the cumulative rate hikes for blue cross blue shields here amounted to 40 percent a 40 rate hike can you imagine a 40 percent raise in your pay most of us can't imagine it and those parents never got it so it isn't working as person after person before said this is a broken system it would be so wonderful to come back here i know you've been hearing about coming back here and saying the same story year after year it would be so cool if we could come back here and say thank you for working with us and using your oversight and regulatory abilities to make sure that our universal publicly funded healthcare system is working for us the way we intended it to and that the financial plan is and we've got a good one we've got more than one good financial plan that's been submitted over the years make and that that's been working imagine all of these people coming here and saying thank you that's what we hope to do in a couple of years instead of continuing these stories thank you Karen amy lester and then jim percher thank you for listening to us tonight good afternoon good evening almost my name is amy lester i'm a mother a small business owner in central vermont and a member of the vermont worker center i'm currently a medicaid recipient with a strong likelihood i'll earn more next quarter and we'll no longer qualify for medicaid we'll be turning to vermont health connect for health insurance through a private provider a rate hike increase will destroy any chance of expanding my business to provide employment to central vermoners and will most likely provide me with a less take-home income there's possible there's also a possibility i may choose to be uninsured which is a risk this 52 year old may have to take i applaud your courage to stand up to the health insurance lobbyist and ask that you look at a zero percent increase i hope there comes a time when these hearings are focused on what's best for vermoners all vermoners not insurance and hospital executives when act 48 is financed and all vermoners have access to quality affordable health insurance that is uncoupled from their work and jobs these hearings will be looking at fine-tuning health care for vermoners that's what this board is supposed to be doing not increasing rates that surely go to a very few imagine a world where everyone in this room had access to health care then vermont would truly be one of the greatest states in this country thank you thank you amy jim percher and then anders ogney well i wonder what uh can you hear me now i don't want to be too loud i wonder what the uh green mountain care board could do to impress upon the legislature and what other powers that be obviously we're here complaining about a rate hike by blue cross blue shield of 15 percent what could you also do about putting a rate hike cap on blue cross and blue shield in light of the testimonies given today it's obvious that they are super wealthy super powerful and they don't need one more dollar from us i'd say a 20-year cap on a rate hike for blue cross blue shield would be a good start if it works out to the benefit of the insured then let's go for 50 years thank you thank you jim anders ogney and then erin lamontane uh my name is anders oggy and i live in northfield um i currently have health insurance through mvp and before that i had a policy with blue cross blue shield uh a year and a half ago um i was hired for a new position within my company um although really i just got more hours that i went from part 10 to full time and i should be there right now by the way but i'm not i'm here instead um and that that pay increase uh that came with that made me ineligible for medicaid uh since that company doesn't offer health insurance benefits and i don't see how they could with what they bring in um i bought a plan on exchange um i haven't been to a doctor once since buying insurance through the exchange um part of that is the copays are a barrier and also i'm scared um a few months ago a friend shared her story with me and her situation completely encapsulates my anxiety about health care and health insurance uh she works part time on a farm while she's parenting um and her partner works full time at the beginning uh at the beginning of the season she got a doctor's bill that equalled what she was gonna make for the summer like her total pay take home pay um it wasn't an emergency or a crisis she was just getting something like a problem checked out um how hopeless and scary is that i feel really scared that something similar will happen to me um with blue both mvp and blue cross blue shield i chose a bronze plan because it was a monthly premium that because the monthly premium was something i could pay after bills food and gas i have about three hundred dollars october in a month um that's not nothing but also i'm not in a place where i can give up a third of my discretionary income for a silver or gold plan um i think i'd be much better off to save that and i know that i'll go with a bronze plan i know that i'll go into thousands of dollars of debt to meet my deductible if i ever have a medical event or need to start seeing a doctor regularly um that's where my fear and seeing a doctor lies and besides the deductible i know they'll need to pay co-pays every time but what other option do i have i could go with a lower deductible plan that would eat up all my extra money um in the premium and that's not a solution i don't understand how mvp or blue cross blue shield could be asking for another rate hike my wages won't go up fifteen point six percent or eleven percent in the next year i'll be lucky to get two percent uh the cost of inflation um and i'm already struggling in april i overdrafted while paying my premium and that was embarrassing and upsetting not long before that i got my tax return back and it was a fifth of what i expected i had miscalculated when signing up for the exchange how much money i would make in the year and nearly all of my tax refund was taken back to repay the insurance subsidies that i received over the past the previous year so i make too much for medicaid and i can't afford the premium decent health insurance even with assistance i'm shelling out money every month for health insurance that provides me zero security my story and that of my friend that i mentioned are not unique i can name dozens of people that i know are in similar spots it's wrong that paying premiums causes us financial stress and it's wrong that when we need health care we can't afford to use insurance or peer deductibles um and i wonder what green mountain care board is going to do in response to this affordability crisis um i ask that you do not raise rates and also i wonder what else you can do thank you thank you anders next is erin lamontain and on deck is christina pasnick well i really butchered that name huh is it eric well you actually got the last name pretty close but the first name is eric okay usually it's the other way around but well done uh so good afternoon my name is eric lamontain i'm a 32 year vermoner a resident of south burlington and i'm the ex the executive director at campaign for vermont thank you for the opportunity for coming here for letting us to come here make these comments thank you to you folks who came up and usually i'm loud enough thank you to you folks who came up and shared so many amazing touching personal stories it was really impressive to see the bravery that was demonstrated here tonight i'm going to speak to something a little bit differently uh i'm going to speak to the core of transparency and accountability blue cross and blue shield mvp they're here they're asking us for more money they're asking to take more money out of the pockets of hardworking vermoners this is not something that should be supported at this time nothing has led us to believe that the accountability and the transparency exists so that we as vermoners can have confidence that our best interests are being held in mind that our money is being well spent and that all is being done to mitigate the need for future increases so to that extent we pose the following questions what has been what has been done to hold the medical institutions accountable for the upward pressure on insurance premiums what is being done to mitigate the need for these annual increases and have other avenues been explored what do we get for our extra money how does this cost increase improve the health of vermoners what or who should we look to so that we can trust that our money is being used responsibly and finally are these increases absolutely necessary for the continued well-being for the state and if so in direct terms why and what are the consequences for not implementing these increases these are questions that must be answered before vermont is asked to shoulder yet another financial burden i'm willing to bet that very few people in here saw their income increase 15 percent or 11 percent the amount that we are at being asked to increase our monthly spending this is real money impacting real people in real ways is going to force real vermoners to make real decisions people are going to have to make real sacrifices as to where and how they allocate their limited financial income limited financial resources this is what is being asked of us so far neither transparency nor accountability to all vermoners has been demonstrated whatsoever until that is done this rate increase must not go forward thank you eric next is christina pasnick and on deck is rachel desalete i'm here on behalf of the national association of social workers vermont chapter and i'm speaking out of concern for my clients and their families my colleagues and also for myself and my own family i don't think i need to say much about the urgent need for affordable and accessible care for all people in our state and the unnecessary tedious and exhausting process of jumping through hoops while you're sick just to get your medical treatment covered i don't need to say much about the greed of insurance companies and pharmaceutical companies in the us or the imperative need for a universal health care system because i think others here have outlined that very nicely today and i thank you for that i am a recipient of blue cross blue shield and i have chronic autoimmune disease so i've personally experienced previous rate increases many other social workers and mental health providers in our state are also blue cross blue shield recipients our work is very rewarding but can also be very challenging and in our daily work we do our very best to provide care and support for others and we deserve to be able to access affordable care when we need it to the average social worker in vermont is making nine percent less than what the national average is and it's about the same for other mental health providers between what i pay and what my employer pays for my medical coverage not including dental and a less than stellar vision plan my medical insurance costs more than 25 percent of what i what i actually make i'm not getting an eight to ten percent raise this year my colleagues aren't getting an eight to ten percent raise this year and my clients are certainly not getting that raise either with the rising cost of living student loan debt and fairly low pay when compared to national average we almost certainly cannot afford the rising health care costs that are being proposed so please say no to these rate increases thank you thank you for seeing a rachel desalette and on deck is caren heart i hadn't planned to talk today because i'm on medicare which i've paid for well my all of my working years they say i'm elderly i thought i had it made foolish me i paid into medicare i thought i'd be covered i thought i'd be all sad i worked as a social worker in the nonprofit field most of my life i retired at 68 not 62 with no pension living on social security and qualified for vhap with social security income when i turned 70 and a half i no longer qualified for vhap i spent four months lots of time every single week examining different policies scrutinizing vocabulary no one uses the same vocabulary they all mean the same different things so that i could compare apples to apples i decided to go with blue cross blue shield i took a chance because the information i was receiving was inconsistent from one navigator to another my premiums from vhap to blue cross and blue shield increased five times equivalent to 25 percent of my social security income and we all know that social security falls short in meeting any monthly expenses in addition even though i have coverage i continue to gather information from insurance providers trying to understand why the insurance is not covering expenses which is the most frustrating thing lastly i am not looking forward to october when i will have to once again research the different insurance options and what they offer and what it will cost hopefully the language the jargon won't change not how i envision spending my retirement time thank you rachel next up is karen hart hi my name is karen hart and this is my first time at a hearing like this and i'm a little bit nervous so i'm going to do my best i'm here not to talk about a personal struggle even though i could as someone who has a 10 year long chronic illness i'm here because i represent an animal hospital here this is small business in vermont that employs 29 employees and we are very busy and we are barely able to afford our costs as it is i'm here to speak what it's like to run a small business and also what it's like to be a hospital um an animal care hospital is very different from a human care hospital there are a lot of differences involved that being said i know what it's like to deal with the rising costs i know what it's like to deal with the rising costs of medication of drugs that you need for your patients every time we get a new order in it seems we have something that's gone up in price and sometimes it's by as much as five or ten dollars a cc for a drug that you need to use multiple ccs of in a patient sometimes it's a medication that is doubled in cost we are lucky in the animal health care field because we get a lot of these things second hand from the human health care field a lot of these things have gone through human health care and there's a generic by the time it gets to us but we are still dealing with these rising costs and i understand that i understand why blue cross blue shield is having these issues and wanting to raise the cost because it is hard that being said we do everything in our power to keep our prices to our clients as low as we possibly can because we know how difficult it is to have an animal and not be able to afford the care that they need again i'm sorry i am nervous and as a small business in vermont um who does employee just under 30 employees it is very important to me and to the business owner to support our employees and we i really really really wish we could give everybody a 10 percent raise but we cannot afford that not only can we barely afford the subsidies that we provide for health care for our employees but with a decent amount of subsidizing we still have ploy employees who can't afford their portion of the health insurance and these are people who work full time in a field that requires them to be very technically skilled um it's also very important to us to support our community which is why we do try to keep our prices as reasonable as we possibly can in the face of rising costs which is why i wonder why this can't be done in the human health care field as well i think the final point that i would like to make is that with all of these rising costs and with trying our hardest to improve the lives of our employees and of my coworkers um and i am i know that i am lucky to have the insurance that i do have and to make you know a whopping $35,000 a year um and again like i said i am one of the lucky ones i still blew through my $5,000 deductible very early on this year with one illness and i am a otherwise healthy 30 year old um it is very very important to me and to the and to the woman who runs the business with me that we are able to provide for our employees and keep this business local to vermont and it gets increasingly difficult every year to do that thank you thank you Karen so those are the names that i have is there anyone else who has not spoken yes come right up front and i did butcher one name real bad so if it's yours i'm really sorry okay hi my name my name is ellen k i live in barry and i've also lived in southern vermont for about 20 years before that um i spoke with a family member today who is on a medication that they need to take every single day and if they don't they have some withdrawal symptoms and it's not pleasant it's scary actually it can happen pretty quickly the um pharmacy that she went to said she has to have these um pills in two different uh i don't know all the technical words right but she has like this many milligrams in this bottle and this many in the other and it's supposed to take them in combination well the insurance company said she can only have a 30 day supply of one of the sizes and a 90 of the other so what she's doing now and a pharmacist gave her this advice because this has happened before is that she's taking a different amount on the two days to even it out right i mean she told me this today on my way to this hearing this is this is to me a company and a whole industry that is only about profit it's not about health care it's a good way to make a lot of money and if they could do it selling widgets they would have been doing that but they're not they're exploiting our need for health so that insurance company who doesn't give a damn about people's health can intervene and say no no she can't have that supply of pills where's the morality here they are only making money off of us that's all and i just want to point out something that is glaringly obvious here have any citizens stood up and defended the rate hike no what a surprise this is really unbalanced i think in my opinion that is all you need to see all you need to understand is that one side is doing something for profit and the entire rest of the state i would imagine opposes it and we're the people who live here so are you going to intervene on our behalf or are you going to help these insurers make more profit out of the people who live here that is what i'm going to leave you with thank you thank you ellen was would anybody else wish to speak so as you can see come forward and as she's coming forward i just want to say that as you can see health care is a very emotional it's a very personal thing it affects us all and i really am so thankful to everyone here for being so respectful to each of the speakers so thank you my name is rose brand and i live in berry i help out with my church's soup kitchen and i see a lot of poor and poor and homeless people and some people are trying to get jobs and a lot of the jobs are part-time jobs like McDonald's and stuff and i think of people that don't make a lot of money and i see a lot of children and i think of a 15 percent rate hike and i think if that comes out of their pay is that somebody's children are not going to get vegetables or nutritious food while they're trying to pay the insurance at the rate hike or is it somebody's car is not going to get fixed and they can't get to work because it's a lot of money and they'll pay the insurance and it it'll come out of somewhere else and maybe they won't get to keep their job because they pay the insurance and then the losing insurance anyway and they'll go back on Medicaid i don't know i just think it's a lot of money where they might have kept their insurance if it wasn't so high and kept their job in there because a lot of kids when they go to school they don't eat the vegetables because if they don't have it at home then they're going to eat it at school that maybe they're eating vegetables now or good food and the increase in insurance they won't get the good food so a lot of people shop at the dollar store for food thank you rose hi my name is britta fischer um last year i told my story and reminded you that this is a moral decision and i didn't think that i was gonna get up and make a statement tonight um but i felt like i couldn't let the hearing end without drawing attention to the irony of the behavior by our own facilitator tonight um earlier we heard commentary from someone who has a chronic illness and cannot afford the care she needs and the suggestion um was to direct her to the office of the health care advocate um i actually work at vermont legal aid which is where the hca is housed um and can personally attest at how helpful they are and what great individuals they are um however i see a pretty large blind spot that's necessary for someone on this board specifically created to transition to universal health care and to help hold and to help the public hold insurance companies accountable um to suggest the ace the hca as an avenue to navigating a broken system that it has taken the responsibility to help us fix it is the job of this board to facilitate a transition to a system where people like the person who spoke earlier can afford health care since that is not what you are working on the one area where we can ask you to help is in with the insurance premiums by allowing rate increases you are turning your backs on us prioritize choosing to prioritize the profits of blue cross blue shield and mvp over the ability of people in vermont to pay for the services they need to keep themselves healthy if you think the heartbreaking story we heard earlier of the person who had to fight with blue cross blue shield to cover her miscarriage the care her miscarriage required and the other stories that we've heard tonight are not related to the insurance premiums think i encourage you to think about it again first using that example if she had been able to afford the monthly premiums maybe maybe you could argue that it was ethical to allow to try to make her pay out of pocket for those services despite having insurance though i would argue against that second as you approve the rate hikes you need to know that while the insurance companies are convincing you that rate hikes are necessary to providing care if that's an argument that you choose to believe then i hope you listened as person after person told stories of their own fights to get care approved by those same companies um sorry nonprofits um who let down people at their most vulnerable every day the goal of the private um health insurance companies is to maximize profits earlier mr mullen you attested that there were no bonuses for denying care however if there are incentives to save money for the company and money can only be saved by denying coverage then i would argue that there are incentives for denying care i am testifying not to ask you to fix this broken system alone in fact i think there are many of us in this room who are eager to do that work with you and i resent the commentary at the beginning of asking us for civility i am angry i am upset people are dying just because we are in a city hall removed from the sites of care where that is happening doesn't mean we can forget about the real world impact while the testimony from the insurance companies has to do with their increased pop pop profits sorry i'm a little nervous um the people impacted by the decisions you make have to stand up until their most intimate and their most devastating stories in the hopes that they'll be able to make you care enough to make a decision in our favor what i'm asking you to remember is that every percent increase you agree to you are affirmatively and actively sending the message that people in vermont deserve to have to make the choice between food and care or housing and care you are supporting the increasing profits of a company that prevents people from accessing lifesaving care you are supporting them as they deny care to people who have had miscarriages who have chronic illnesses and who are fighting for their lives and i hope you remember all of our faces as you make that choice thank you very much is there anyone else that would like to speak yes come come forward hi my name is pistola well yeah and i am from barrett i'd like to ask green mountain care board a question i have a chronic illness if you raise the rates of health care what is a senior citizen as well as myself to do i am a diabetic type two for the rising costs of insulin we have to decide do we pay for our health care or do we go without our essential medication and i thank you for listening to me thank you is there anyone else if not i want to thank you very much for coming out you know it's uh really good to put the human face behind health care i can tell you that um this board tries very hard every day to make the right decisions um sometimes we get it right sometimes we don't um but we continue to try thank you yes so these insurance rates that we're currently considering don't impact medicare or Medicaid so i would need to know more about her insurance to know specifically how it would impact her and i'm happy to speak with her afterwards so it it depends like this is a very limited rate filing but hopefully if she's on medicare or medicaid then this specific filing shouldn't impact her and unfortunately the lines get blurred in health care and i know that um there are many passionate stories what we're dealing with in this decision-making process strictly relates to the exchange product so it doesn't affect medicaid or medicare or um insurance that um is part of a self insurance program or a large group program this is the individual market in the small group market but it's important to hear everyone's stories anyways because we're all in this together and everyone should be able to seek care in vermont and know that they're getting quality care and that they'll never be turned away so that's a that's a different product it won't impact you because medicare supplemental we actually don't review that's reviewed by the department of financial regulation this is strictly the individual and small group plans through the exchange so there are a number of factors that have caused them to um not be able to break even they're the there's a trend on prescription drugs especially on specialty drugs these are drugs that can really help someone especially someone with cancer or leukemia but they're very very expensive and that trend alone is is about half of what they have requested in their rates and there's a number of other things it's utilization it it there are a lot of strong actuarial arguments that they have posed and what the board must do now is try to figure out a way to put what is our statutory charge because we have to follow the law as well so we have to make decisions to make sure these rates um not only um are trying to protect the consumer but we also have to make a decision that would not allow um the insurance company to go insolvent because we certainly would not want our only Vermont insurance company to be out of business except who would be left to provide the coverage but unfortunately this board cannot put in place universal health care that would have to be a legislative decision approved by the governor she's right now sitting in a rehab she's got maybe two months to two years to left you've had talks before yep I'm very angry because all Blue Cross Blue Shield wants money money money money now pray the CEO is sitting in here if he is he gets it for another pocket and goes sits on his little cloak nobody's laughing thank you for that have a good night everyone