Bill Providing Primary Care for All Vermonters Viewed as First Step to Single Payer

August 21, 2017

Vermont Public Radio

A plan to create a publicly financed primary health care system for all Vermonters will be a top priority for the Senate Health and Welfare committee during the 2018 session.

The legislation enjoys strong support in the Senate where 13 senators have signed on to the bill as co-sponsors.

The bill calls for a comprehensive study of a plan that would provide all Vermonters with primary health care services. The proposal would be financed using tax dollars; part of the study would include a review of possible tax sources.

Washington County Sen. Anthony Pollina is one of the sponsors of the bill. He says the current health care stalemate in Congress offers an opportunity for individual states to create their own innovative solutions.

"As much as we'd like Congress to make it happen, I think it's pretty obvious that the states are going to have to take the lead and Vermont has already been in the lead, so it's appropriate for us to continue to move forward and provide that leadership," said Pollina.

Pollina says the legislation will ensure that all Vermonters have access to primary care services without incurring large out-of-pocket expenses.
"Right now people avoid going to the doctor because of the costs and we still don't have everyone covered the way we should." —senator Anthony Pollina

“Right now people avoid going to the doctor because of the costs. And we still don't have everyone covered the way we should so if we do universal primary care we really open the door to allowing everybody the ability to maintain their health," said Pollina.

Addison County Sen. Claire Ayer is the head of the Senate Health and Welfare committee. She's also a sponsor of the bill.

Ayer views the legislation as the first step in setting up a publicly financed single payer health care system in Vermont.

"We would have the benefits of having healthier workers and healthier students and that sort of thing, but we'd also be setting ourselves up for eventually moving to health care for everybody, universal health care which is where I think we're going to go," said Ayer.
"We'd also be setting ourselves up for eventually moving to health care for everybody, universal health care which is where I think we're going to go." — Sen. Claire Ayer

Under this approach, individuals would still purchase insurance to cover health care services that don't fall under the definition of primary care. The proposed study would determine exactly which services would be included in the tax financed plan.

Ayer thinks the legislation will help reduce health care expenses in several ways.

“The premiums would come down because people are healthier, and the premiums would come down because primary care is taken out of an insurance setting and is paid for with tax dollars," said Ayer.

While the legislation only calls for a comprehensive study of this plan, Ayer is hoping her committee will make enough progress on the bill that some parts of it can be voted on next winter.

"I'd like to take some time working on it this fall and in the session to see if we could actually do something that brings people without primary care into the system," said Ayer.

The Scott administration is not enthusiastic about this approach. Administration Secretary Suzanne Young says it's doubtful that the governor would support a plan that's financed using tax dollars.

"The governor's approach to looking at any idea is whether it helps grow the economy and makes Vermont more affordable while protecting the most vulnerable,” said Young. “So we would have to see what the plan looks like after they did some study and how it would be financed."

Young says Scott views payment reform efforts as a better way to control health care costs.

"I think the governor is more focused now on the All Payer model which we have as a pilot that's covering about 30,000 Medicaid lives and see that as an alternative to a single-payer approach," said Young.

It's likely that the Senate Health and Welfare committee will hold some hearings on the primary care bill this fall.