Lobbying on Vermont Health Reform Bill Cost Alot, But Exactly How Much is Unknown

July 25, 2011

Daily Journal
AP, Dave Gram

MONTPELIER, Vt. — Hospitals, doctors, drug companies, insurers and others with a stake in health care spent more than $750,000 lobbying at the Vermont Statehouse this year as lawmakers debated landmark legislation designed to put Vermont on the road toward universal health insurance.

But exactly how much was spent on the bill itself is impossible to tell. That's because Vermont's lobbyist disclosure law is vague, and the reporting system used to implement it is not specific enough to allow for a dollar-by-dollar accounting, according to lobbyists, good-government advocates and lawmakers.

The head of Common Cause-Vermont called the lobbyist reporting system "regrettable;" longtime Montpelier-based lobbyist Kevin Ellis called it "horrible."

Ellis' firm, KSE Partners, complies with the law's requirements, Ellis said. For a citizen trying to learn about what's being spent to influence legislation, the result is "accurate but not necessarily true," he said with a laugh.

Secretary of State Jim Condos says a key problem is a lack of money for system improvements.

"We're going to have to work with the Legislature to improve lobbyist disclosure overall," he said. "We need to make it more transparent."

Monday was the deadline for filing reports about lobbying activity for the second quarter — April, May and June — of 2011. An Associated Press review of first- and second-quarter lobbying reports showed that the Vermont Association of Hospitals and Health Systems appeared to lead the lobbying spenders with more than $108,000 in spending in the first quarter and an additional $43,000 in the second.

But there are at least two problems with concluding that the association was the leading spender on the health care bill:

— Much of the time spent at the Statehouse by the hospital group's CEO, M. Beatrice Grause, and vice presidents Jill Olson and Michael Del Trecco, was not devoted to the big health care bill, known as H.202, Grause and Olson said. Instead, they were fighting over an issue in the state budget, trying to minimize cuts in reimbursements to hospitals in Medicaid and other public health insurance programs, as well as tracking 20 other bills.

"For us, the most important issue of the year was the budget," Grause said.

The hospital association didn't take a formal position on H.202. That's because it's still very early in the process of developing the new public health insurance system envisioned by Gov. Peter Shumlin and lawmakers. Questions — including what health procedures will be covered, how the system will be paid for and how much hospitals will be paid — are being left for later.

— Some lobbyists and lobbying firms are focused on a range of subjects, and it's impossible to determine how much of their staffers' time was devoted to health care in general, never mind a specific bill related to health care.

KSE Partners, formerly known as Kimbell Sherman Ellis, reported lobbyist compensation of more than $297,000 for the first three months of the year.

Among the firm's clients are Blue Cross Blue Shield of Vermont and the Washington-based health insurance industry group America's Health Insurance Plans. But KSE also lobbies for a range of other clients, ranging from Green Mountain Power Corp. to the Toy Industry Association Inc.

Sorting out how much of the firm's work was for health care clients, versus utilities or toy makers, then sorting how much of the health care lobbying was devoted to H.202, is impossible, said Wally Roberts, executive director of the clean-government group Common Cause-Vermont.

"Most of the state's websites are very poorly designed and very difficult to use for things like this," Roberts said. "It's very regrettable that the state doesn't make this more easily available and searchable, so the average Joe Citizen can go on this site and figure out how his life is being affected by lobbyists and campaign donations."

Health care represents nearly a fifth of Vermont's gross domestic product, according to state officials.

It's clear from looking at the lobbyist disclosure reports that health care is a big-ticket item.

One way to measure its importance at the Statehouse is to count how many of the 389 lobbyists who filed disclosure reports April 25 list health care industry clients. The answer: more than 130.

That doesn't count pharmaceutical industry representatives or mental health advocates.

But for all that, some of the most effective lobbying on the health care bill this year isn't required to be disclosed in the lobbyist reports, because it came from the Shumlin administration or was done on a volunteer basis.

Administration officials largely wrote the bill and played key roles in shepherding it through the legislative process, said Rep. George Till, D-Jericho, a physician and member of the House Health Care Committee.

Much of the grassroots energy behind the bill came from the Health Care is a Human Right Campaign, spearheaded by the Vermont Workers' Center.

The campaign's volunteers were a constant presence in the Statehouse. When two senators won initial approval of an amendment to deny coverage to undocumented immigrants, campaign members could be seen buttonholing senators in Statehouse hallways, demanding that the amendment be stripped from the bill, which it was.

Workers' Center executive director James Haslam said in an interview that his group's goal was that "democracy doesn't become the arena of paid professionals, but just ordinary Vermonters taking action. That's what we've seen and that's what's supposed to happen in a democratic system."