It’s battered and beaten, but the House’s health care reform bill is still alive. Many Democratic lawmakers, however, don’t think the legislation goes nearly far enough. And legislators still haven’t figured out how to raise the money needed to support the few initiatives that remain.
It wasn’t so long ago that lawmakers were contemplating a $190 million health care reform proposal. The plan, put forth by Gov. Peter Shumlin, was designed to rectify longstanding structural deficiencies in Medicaid funding, deficiencies the governor blames in part for the rising costs of private health insurance.
Last month, House lawmakers scaled the plan back to about $68 million – less than governor wanted, but still enough, they said, to invest in meaningful reforms.
The plan took another hit a few weeks ago, when a committee knocked the grand total down to about $30 million.
Now, that same piece of legislation has been whittled down to a wisp of its former self. And the $15 million package that passed through the House Committee on Health Care by an 8-3 vote Thursday was for some Democrats a sad end to a dispiriting process.
“I feel like what’s really happening is it’s harder for us to raise the money to do the right thing than it is to let premiums go up for Vermonters. That’s really what I think,” said Johnson Rep. Mark Woodward, a Democrat who sits on the House Health Care Committee.
House lawmakers rejected the payroll tax that would have been needed to fund the governor’s proposal. But Woodward says that in a Democratically controlled House, he figured there’d at least be support for the half-cent per-ounce tax on soda and other sugary beverages needed to fund a previous version of the reform bill.
“I guess I’d say I’m really disappointed in my Democratic caucus that we couldn’t muster the votes to pass the revenue package that even came out of Ways and Means last week,” Woodward said.
"This is not perfection. I'm not saying it is. But it is the amount of money that apparently can be raised." - Rep. Bill Lippert, chairman of the House Health Care committee
The bill up for consideration now would help low-income Vermonters pay for co-pays and deductibles, and modestly increase Medicaid reimbursement rates for primary care doctors. Hinesburg Rep. Bill Lippert, the Democratic chairman of the House Committee on Health Care, says it doesn’t go nearly as far as he’d like.
“This is not perfection. I’m not saying it is,” Lippert said. “But it is the amount of money that apparently can be raised.”
The Health Care Committee had been considering a $2 per-pack increase in the cigarette tax, which would have brought state taxes to $4.75 per pack. The tax hike would bring in about $8.7 million annually, and draw down federal matching dollars needed to pay for the full $15 million plan.
But Rep. Ann Donahue says that would be a massive increase to an already regressive tax that hits the low-income and mentally ill people that statistically make up a disproportionate share of the smoking population.
“We are really doing not only a regressive but offensive tax that is taking money from people who are on disability,” Donahue said.
The Health Care committee opted instead for a 25-cent per-pack cigarette increase that won’t raise close to enough money to support the legislation. The bill heads next to the House Committee on Ways and Means, where lawmakers will find an alternate revenue proposal.
Lawrence Miller, chief of health care reform for the Shumlin administration, said the governor remains firm in his belief that Vermont should use a .7 percent payroll tax to generate about $90 million in state funds annually. The state would be able to use the money to draw down another $100 million in federal funds. Shumlin said the expense of the payroll tax to businesses would be returned to them in the form of reductions in private insurance rates, since increased Medicaid rates to doctors and hospital would relieve upward pressure on commercial insurance policies.
“The governor feels very strongly that we should be pulling down the maximum federal resources to be able to support our Medicaid program, and figuring out how to do that this year,” Miller said.
