April 15, 2014

 Vermont Digger

A new legislative proposal would freeze the funding for the Shumlin administration’s transition to a universal health care program if officials don’t present lawmakers with public financing details by February 2015.

“The clock is running out. They have got to deliver us a plan by that time if (the program) is going to be viable,” said Rep. Mike Fisher, D-Lincoln, chair of House Health Care.

Robin Lunge, the administration’s director of Health Care Reform, said she’s “comfortable” with the date included in the House version of the health care reform bill.

Earlier this year, Gov. Peter Shumlin backed away from a pledge to present a financing plan by the end of the current session, creating anxiety about the program’s viability even among lawmakers who support his health reform agenda.

Shumlin said he chose to delay because his team didn’t have all the details ironed out, and he would rather get it right than meet an arbitrary deadline – even one he set for himself.

The delay frustrated Republicans, who tried unsuccessfully to include a similar provision to cut off funding if a financing plan was not forthcoming.

The administration now plans to offer a report detailing information it has collected on Vermont’s current health care system as context for proposed financing legislation in the next biennium, according to Lunge.

“Since the Legislature will be in session, I’m assuming if we needed additional time to get it done we would have the conversation at that time,” Lunge said.

If the House Health Care provision becomes law, and lawmakers aren’t willing to negotiate on the funding, Lunge said it’s difficult to predict what that might mean for single-payer.

“It’s such an abstract it would be hard to imagine where we would be and what we would have left to do,” she said, adding that it’s hard to know how much of their planning and implementation budget would be spent by that point.

Deb Richter, a longtime single-payer advocate with the group Vermont Health Care for All, said the provision reflects the reality that Vermont has a finite window to pull the trigger on a universal health care program.

The state needs to define elements of its plan, including how it would be paid for, in order to apply for a federal waiver to proceed with the program.

Robin Lunge, director of Health Care Reform for the Shumlin administration, speaks at a Vermont Health Connect forum in Montpelier last month. Photo by Roger Crowley/for VTDigger
Robin Lunge, director of Health Care Reform for the Shumlin administration, speaks at a Vermont Health Connect forum in Montpelier last month. Photo by Roger Crowley/for VTDigger

Richter and other advocates believe that if the application isn’t submitted to the Obama administration, which has shown a willingness to let states innovate in the health care arena, the entire program might be in jeopardy.

A new president will take office in 2017 and he or she might be skeptical of, or even opposed to, Vermont’s health reform agenda.

Lawmakers would need to pass legislation defining how the program will be paid for, what it will cover and how it will be administered during the next biennium in order avoid seeking a waiver from the next president.

The House Health Care Committee passed a much altered and expanded version of the Senate health reform bill, a summary of which can be found here.
The bill is likely to go before the House Ways and Means Committee before the House floor, because the underlying Senate version had a provision that raised revenue. However, the House Health Care Committee’s version struck that provision.