MONTPELIER — Sen. Richard McCormack, D-Windsor, waited two decades to cast a vote in support of a bill establishing a health-care system serving all Vermonters — but he said Tuesday’s 21-9 vote wasn’t a groundbreaking event headed for the history books.
“This, today, isn’t the great moment. The great moment will happen in 2017,” McCormack told his Senate colleagues as they wrapped up two days of debate on health reform legislation. Under the bill, the state would move in 2017 to a consolidated health insurance system that covers all Vermont residents — assuming a host of conditions have been met.
McCormack has seen health reform dreams evaporate before, so he said he was wary of celebrating too soon.
Sen. Vincent Illuzzi, R-Essex/Orleans, who has served in the Senate longer than McCormack, judged the bill to be far from historic in scope. He opposed its passage.
Much of the bill puts in place a new insurance marketplace mandated by the federal Affordable Care Act, Illuzzi said: “We are simply implementing what we were asked to do by Congress.”
The rest of the bill he characterized as a planning document: “This is a wholesale delegation of authority to plan Vermont’s health-care future to the governor and his administration.”
The generally muted reaction to the final vote on the Senate floor contrasted with more exuberant expressions among longtime advocates for a single-payer health-care system.
Gov. Peter Shumlin, who made progress toward a single-payer health-care system a priority for his administration, cheered passage of the Senate bill within minutes of the vote.
He sees the legislation as a bold “first-in-the-nation” step toward a system that would cover all Vermonters, control health-care costs and free employers of the burden of providing health insurance.
Dr. Deb Richter, who spent hours in the Senate gallery in recent days and said she had made 400 speeches in the past decade promoting the benefits of a single-payer system, called Tuesday “one of the best days of my life.”
“We have said ‘historic’ before, but it has never been true,” she said. “This is the first time a state is establishing a true health-care system where everyone is included.”
Senators debated proposed changes to the legislation for four hours, agreeing to only a few.
Sen. Peter Galbraith, D-Windham, proposed setting up a public insurance option — just in case the state wasn’t able to secure all the federal waivers to move to a consolidated government-financed model.
Sen. Claire Ayer, D-Addison, who shepherded the bill through the lengthy deliberations, said it was an option the Senate Health and Welfare Committee would like to study next year. She won rejection of the public option for now.
Illuzzi pushed two amendments intended to quell business worries about the federally mandated health-insurance market that will launch in 2014.
Ayer said Illuzzi’s requests would shut doors on how the market should be set up before lawmakers and state officials had all the data to make informed decisions.
Sen. Randy Brock, R-Franklin, tried to change the date when state officials would recommend how to pay for a consolidated health-insurance system. The bill says the plan is due Jan. 15, 2013.
He wanted the financing plan delivered Sept. 15, 2012 — so the November election could be a referendum on the unification plan.
Ayer said she’d like the information before the election, too, but she didn’t believe it possible to deliver the plan that early. Too many other decisions have to be made before financing can be figured, she said.
Ayer and other defenders of the bill acknowledged repeatedly there are many questions still to be answered about the vision for a reformed health-care system set out in the bill.
“Each of us is determining whether we can wait for those answers,” Ayer said.
Sen. Diane Snelling, R-Chittenden, voted against the bill because of the many unanswered questions. She objected to putting the state on course toward a consolidated system before knowing more answers. “I remain unconvinced we need to move this fast,” she said.
Sen. Richard Mazza, D-Chittenden/Grand Isle, was one of two Democrats to vote against the bill. He said his worry was that businesses don’t like the measure.
In recent weeks, he arranged for 32 business leaders to meet with the Shumlin administration to voice their concerns and get answers to their questions.
“None of them have changed their minds,” Mazza said. “I’m not going to turn my back on businesses that really have concerns.”
Marge Power of Montpelier, a single-payer supporter who sat through almost every discussion lawmakers have had about health care since the beginning of the session in January, noted most Vermonters won’t feel much impact from the bill in the coming year.
“It is going to be even more disappointing than federal health reform,” she said. The federal law immediately mandated that insurance companies allow parents to keep children on their policies until age 26, for example.
“This isn’t going to make a big splash,” Power said, “but without it, how can we move forward?”
Power, however, has something to show from all her hours monitoring deliberations on the bill. She has knit five sweaters, and Tuesday she cast white yarn onto needles to begin a sixth.
She’ll bring her knitting today for the House Health Care Committee meeting to review how the Senate bill compares with the version the House passed.
The House and Senate will likely appoint negotiating teams soon to iron out the differences.