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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Gov. Shumlin Urges Lawmakers To Keep Eyes On Single Payer Prize

Angela Evancie
VPR File Photo
Governor Peter Shumlin addresses the House and Senate Health Committees.

In a rare appearance by a sitting governor before a legislative committee, Gov. Peter Shumlin Tuesday took responsibility for problems on the new health insurance exchange, but said the shortcomings only reinforce his case for a publicly financed, universal health care system.

“No one is more disappointed than I am that we fell short of our rollout in the exchange, and I take responsibility for those failures,” Shumlin said. “I know that we have work to do to restore Vermonters confidence in our ability to get health care right.”

Shumlin, however, said the glitch-filled opening of the new website shouldn’t detract from the urgency for a more complete overhaul of the health care system.

“So let me be very clear: I have never been more convinced of the need to keep moving forward. I have never been more certain that we’re on the right path. And I’ve never been more committed to ushering in America’s first universal affordable publicly financed health care system right here in Vermont,” Shumlin said.

But opponents of single-payer say issues on the exchange don’t bode well for the governor’s big picture plans. Darcie Johnston, co-founder of Vermonters for Health Care Freedom, said that if the state can’t get the exchange right, then it has little hope of succeeding in single-payer.

“Because the big story here is that we couldn’t do the easy part at all successfully, which was the exchange. So now we’re moving onto the hard part with no safety net underneath us. It’s a tough, tough road economically, and I don’t see how we get there.”

Shumlin’s testimony before the House and Senate health care committees comes as lawmakers prepare to scrutinize an insurance exchange that has fallen well short of consumer expectations. 

Shumlin asked legislative leaders last week for permission to address the committees, in an attempt to preemptively address many of the hard questions his top cabinet officials are likely to face this year. 

“Like the rest of the country and the federal government, we’ve had our struggles,” Shumlin said. “I said at the beginning of this process that for those who wanted to focus on the negative, there would be no shortage of material. The website limped out of the gate and it’s only now beginning to hit its stride… The contractors we hired to build it have under-performed at every turn.” 

But Shumlin said lawmakers can’t let disappointment in the exchange discourage them from pursuing the longer-term quest for the most dramatic state-level reform of the health care system in the nation’s history. The plan aims not only to eliminate the private insurance market in favor of a publicly financed system, but would also the change the manner in which health care is paid for.

Moving away from a fee-for-service model that rewards providers for the quantity of services provided, as opposed to the quality of care provided, is key, Shumlin said, to curbing costs in a $5 billion annually industry that now accounts for about one-fifth of the state’s gross domestic product.

“Vermonters did not elect me to nip around the edges of health care and our health care system,” Shumlin said.

Sen. Claire Ayer, the Democratic chairwoman of the Senate Committee on Health and Welfare, said she remains convinced of the need for a system of universal care. But she said moderate Democrats in the Senate will need convincing the state is still on the right path.

“In the middle is this group of about 15 to 20 people who really need to understand it, and they are the ones who are most shaken by the huge bumps in the road we’ve had rolling out the exchange.”

Even as he vowed to move ahead on public financing, Shumlin said he wouldn’t pull the trigger on a single payer plan until he was assured the new system would succeed in lowering costs.

The governor on Tuesday also announced plans he said will more quickly resolve the glitches plaguing the insurance exchange, called Vermont Health Connect. He said he’s temporarily reassigning Secretary of Commerce Lawrence Miller to the Department of Vermont Health Access, where he’ll use his “practical business management” experience to identify and remedy problems.

Shumlin said he’ll also commission an independent review of the exchange rollout, to find out what went wrong, and how to make sure it doesn’t happen with the state’s next big information technology venture.

The administration has a list of “preapproved vendors” to which it will soon release a request for proposals. Administration officials declined to release publicly the estimated cost of the review, saying it will weaken the state’s hand in the bidding process.

Rep. Michael Fisher, D-Lincoln, the chairman of the House Committee on Health Care, said the independent review doesn’t eliminate the Legislature’s responsibility to play an oversight role.

Fisher said his committee will seek answers from the administration about what went wrong with the exchange, why, and what’s being done to resolve the issues. The state has yet to succeed in implementing a payment function that will allow the small businesses and individuals purchasing insurance through the exchange to submit payment electronically to insurance carriers.

Legislators had time to ask only a few questions of Shumlin before the governor had to depart for another engagement. But one Democratic lawmaker got to ask what kind of tax Shumlin plans to use to fund the publicly financed health care system.

Shumlin has indicated that the answer to that question may be revealed at least partly before the end of the session. But he didn’t tip his hand Tuesday.

“I don’t have all the answers, and everything is on the table,” Shumlin said. “Everything’s fair game, and I will be a collaborative partner in this conversation – promise.”

House Minority Leader Don Turner said he and his Republican colleagues will pressure Shumlin to deliver an answer to the financing question soon.

“We feel that the administration has spent way too much money studying this, and have not come forth with an actual proposal,” Turner said. “If the governor cannot tell Vermonters how much it’s going to cost and how it’s going to be paid for, then we’re not going to support any more money until they do that.”

The Vermont Statehouse is often called the people’s house. I am your eyes and ears there. I keep a close eye on how legislation could affect your life; I also regularly speak to the people who write that legislation.
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