Vermont Ponders Ripple Effect of Changes to Health Care Law

March 26, 2012

In an interview conducted for VPR news, Governor Peter Shumlin explains that single payer is still possible and necessary in Vermont, and that he is firmly committed to creating a single payer system in Vermont regardless of the outcome of the Supreme Court decision regarding the Affordable Care Act.   See below:

Vermont Public Radio

Bob Kinzel

(Host) Governor Peter Shumlin says his health care reform initiatives will still be viable if the U.S. Supreme Court strikes down the federal Affordable Care Act.

But as VPR's Bob Kinzel reports, the state's top health care official doesn't completely agree with that assessment.

(Kinzel) Legal experts say there are a number of options available to the Court. The justices could find the law to be constitutional, they could strike down the individual mandate or they could throw out the entire law.

Anya Rader Wallack is the chair of the Green Mountain Care Board - a group that oversees virtually every aspect of health care in the state. She says the Governor's health care plan can survive if the individual mandate is struck down.

But she says it will be much more difficult if the Court throws out the entire law because individuals and businesses in Vermont would lose several hundred million dollars in federal tax credits.

(Rader-Wallack) "I think that's much more significant for Vermont in the sense that there's significant federal funding that's available to Vermont under the Affordable Care Act to pay for subsidies in the form of tax credits to individuals who are currently uninsured."

(Kinzel) Governor Peter Shumlin does not agree. He says his health care plan can survive without the federal subsidies.

(Shumlin) "We are not relying on the federal subsidies now, we won't be relying on them necessarily under the Green Mountain Health care bill. If we have them it's great, it's gravy but we're going to reform this system with or without federal subsidies - that our system of reform is not dependent upon federal subsidies."

(Kinzel) Shumlin insists that Vermont can move forward because he says implementing a single payer system will reduce overall health care costs.

(Shumlin) "The point of our effort is to find ways to spend less money - which is easy to do because we waste a ton of money in the system, to move to a system that uses both technology and payment reform to ensure that our providers get paid for keeping people healthy not for the number of fees or number of services they provide to you."

(Kinzel) But Rader Wallack says it will be very difficult to actually reduce overall spending. She says her goal is to bend the curve of the growing cost of health care.

(Rader-Wallack) "I think it is the more realistic outlook - so, what's the amount that we're spending and then how much does that increase each year... Most of what we're looking at reducing is the trend."

(Kinzel) Rader Wallack says the Green Mountain Care Board is looking at several different payment reform plans and she hopes to have a pilot program in place by the end of the year.

For VPR News, I'm Bob Kinzel in Montpelier.