HEALTH CARE REFORM BILL COULD FALL APART IN CONFERENCE

May 06, 2014

 Vermont Digger

By: MORGAN TRUE

After gathering testimony from dozens of witnesses and spending hours crafting a bill in several committees starting in January, the Legislature’s primary piece of health care legislation this session is likely going nowhere.

Sen. Tim Ashe, D/P-Chittenden, is chair of the Senate Committee on Finance. Photo by Roger Crowley/for VTDigger
Sen. Tim Ashe, D/P-Chittenden, is chair of the Senate Committee on Finance. Photo by Roger Crowley/for VTDigger

The bill, S.252, went before a committee of conference between the two chambers on Tuesday. Sen. Tim Ashe, D/P-Chittenden, told the other members of the committee that the timeframe for adjournment, which is expected to be Saturday, would not allow for the Senate and House versions to be reconciled.

Rep. Mike Fisher, D-Lincoln, confirmed that to get the bill passed by Saturday, the conference committee would have to complete its work Tuesday.

“We can’t dedicate the time to digest the differences (between the two versions) in one day, let alone reach agreement, so maybe we should just bail,” said Ashe, chair of the Senate Finance Committee.

Fisher, chair of the House Health Care Committee, said the schedule for adjournment — which Ashe referred to as a “false construct” — is set by legislative leadership and out of the conference committee’s control. He urged Ashe and other senators to work toward a resolution.

“I think we owe it to ourselves and the hard work of many committees to work our way though as much as we can and do our best,” Fisher said.

“One day for the health care bill?” Ashe asked.

“That would be my goal,” Fisher responded.

“Many days for rinky-dink bills all over the building, but one day for this one?” Ashe asked.

“That’s the goal,” Fisher said.

The House of Representatives could vote to suspend its rules to allow legislation to move more quickly, but that would require a two-thirds vote. House Republicans have said that they won’t vote to suspend the rules for bills they opposed earlier in the session or bills that the caucus votes internally not to support.

“The way the vote went on the floor, I doubt we would allow a suspension of the rules on [S.252],” said House Minority Leader Don Turner, R-Milton.

The same could be true for a litany of other bills, some of which – like the budget and the tax and fee bills – must pass for state government to continue to operate.

However, it appears that House Speaker Shap Smith, D-Morrisville, has no intention of extending the session for the health care bill.

“I don’t care (if it passes); it can die. It’s not a must-pass,” Smith said.

In an afternoon session of the conference committee, Ashe delivered what he called “the one day option,” which uses the Senate language for virtually all sections that the two versions have in common and strikes several sections added by the House.

The Senate proposal did not include a section in the House bill that would impose a deadline of January 2015 for the governor to present a financing proposal for universal health care.

Other sections the Senate proposal left out include a provision raising the employer assessment to generate additional revenue, a provision increasing regulations for and banning certain practices by pharmacy benefit managers and language that would create a pilot and study program for the use of adverse childhood experience questionnaires.

The Senate proposal left in a controversial provision relating to the regulations for and practices of urgent care centers.

However, if the House doesn’t agree to the Senate’s terms then those terms are moot and the urgent care provisions would be too.

Fisher said he had a counter-offer for the senators that he planned to deliver by hand Tuesday night, the details of which were not immediately available.

If the senators do not agree to his offer, Fisher acknowledged that the bill could not pass unless the date for adjournment is changed.

It’s possible that sections of the bill could be splintered off and attached to one of the “must pass” pieces of legislation, but with the exception of the employer assessment provision — a version of which is included in the budget — it’s not clear if there’s an appropriate vehicle for many aspects of the bill.

The health care bill was originally introduced by Sen. Peter Galbraith, D-Windham, as a concrete proposal to finance universal health care, but it failed to gain traction, because at the time the Legislature expected Gov. Peter Shumlin would come forward with his own financing proposal that would set the legislative agenda for health care reform during the session.

When the Shumlin administration’s proposal never materialized, Ashe turned to Galbraith’s bill as a vehicle to advance the state’s health care reform agenda legislatively as well as adding several housekeeping measures such as tweaking the employer assessment – a per employee penalty for not offering affordable health care.

The bill was greatly revised in the House, where the House Health Care Committee spent weeks taking testimony, revising sections and adding new ones.

Both the Senate and the House versions of S.252 are aimed at clarifying and reaffirming aspects of Act 48, the state’s 2011 universal health care law, and ensuring lawmakers will have access to the information they need during the next legislative session to pass laws that will set the program in motion.

While the principles laid out in the bill don’t need to be enshrined in statute to guide lawmakers going forward, Fisher said he was disappointed that sections in the House bill altering current practices by actors in the health care arena might be lost.