Dr. Dynasaur

"In Vermont, Medicaid insurance programs for pregnant women and for children up to age 18 are known collectively as the Dr. Dynasaur program." 

Vermont Agency of Human Services
Department of Prevention, Assistance, Transition, and Health Access
Office of Vermont Health Access
"The primary goal is to assure access for pregnant women and children to a full range of health care services with a strong emphasis on prenatal and preventive care, and to provide a system of coverage in concert with private health insurance that ensures universal health insurance coverage for all Vermont children."
--Office of Vermont Health Access website 

Con Hogan, who served as Secretary of the Agency of Human Services from 1991-99, described the program thusly:
"Dr. Dynasaur is a marketing name of a pudgy little dinosaur with a stethoscope that basically provides health care for children.  And Vermont has been very generous in that effort so in effect almost all children in Vermont have access to health care coverage.  In Dr. Dynasaur, instead of calling it a welfare program or a public program, we tried to find an image that the general public could relate to and feel comfortable in signing up for that kind of help for the kids.  So Dr. Dynasaur is a marketing device to try to have people comfortable to enroll their children in the public health care system."

Dr. Dynasaur Overview
Adapted from "Vermont's Dr. Dynasaur Health Insurance Program" on the OVHA website
Eligibility: Covers pregnant women up to 200% of the federal poverty level and children under age 18 up to 300% of the federal poverty level.

Coverage: Prenatal care, routine check-ups and immunizations, inpatient and outpatient hospital care, prescriptions, x-ray and lab tests, dental and vision services...

Program Fees: $20 per month per family for family income between 185% and 225% of the federal poverty level; $50 per month per family for family income between 225% and 300% of the federal poverty level; $24 per month for family income between 225% and 300% of federal poverty level if the family has other insurance coverage.

Dr. Dynasaur has its origins in a state program introduced in 1989 to cover children age 6 and under who did not qualify for Medicaid.  In 1992 it was expanded to cover children under age 18, and in 1998 the eligibility threshold was increased from 225% of the federal poverty level to 300% of poverty level.  According to the OVHA, Dr. Dynasaur currently covers about 56,000 people.

Medicaid is the "safety net" program that covers low-income women, children, elderly and disabled.  It is jointly funded by the federal government and the individual states.  Each state has its own Medicaid program.  In Vermont the eligibility categories are: aged, blind/disabled, Dr. D, ANFC/Family, VHAP and VHAP-Rx.  Some states are more generous than others; there are mandatory services, which a state must provide, and optional services.  Cost is a major concern for all the states (see the Kaiser Commission on Medicaid and the Uninsured preliminary report from July 2002) and Vermont is no exception.  An August 2000 report from Vermont's Joint Fiscal Office noted, "From 1990 to 2000, total Vermont Medicaid expenditures have more than tripled (an average annual rate of about 13.7 percent).  This growth is attributable to two factors: increases in health care costs and an increase in the number of people covered.  Enrollment in the program roughly doubled during that period."

Copyright © 2002  Eric M. Appleman/Democracy in Action