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Health Care Leaders In Vermont Sound Alarm Over Senate Bill In D.C.

A sign for the University of Vermont Medical Center in Burlington.
Taylor Dobbs
VPR File
Health care executives in Vermont say proposed legislation in the U.S. Senate could severely undermine medical reforms already underway in Vermont.

Key health care officials across Vermont say efforts in Congress to repeal the Affordable Care Act could saddle the state’s medical system with new and expensive problems.

Republican leadership in the U.S. Senate has delayed a vote on its controversial health care bill, but the push to repeal and replace the Affordable Care Act marches on.

Todd Moore is the CEO of an organization called OneCare Vermont. It’s a relative newcomer to the Vermont health care universe, and it’s responsible for orchestrating a major shift in the industry.

Moore is keeping close tabs on the health care debate in Washington, D.C. And when Senate Republicans unveiled their version of the American Health Care Act last week, Moore was concerned by what he saw.

“It’s going to be a major disruption for Vermont health care if that passes,” Moore says.

Of specific concern to Moore are proposed reductions to a federal Medicaid program that now provides insurance to nearly a third of Vermont residents. If a portion of those patients end up losing coverage, as the independent Congressional Budget Office has projected, then Moore says Vermont’s grand payment reform plans may have to be suddenly curtailed.

“It’s going to complicate our lives and slow down the things we’re working on,” Moore says.

"A small change to Medicaid and some of the involvement from the federal government could be devastating for Vermont." — Gov. Phil Scott

Moore isn’t the only health industry executive sounding the alarm. Don George, CEO of Blue Cross Blue Shield of Vermont, says the state’s rate of uninsured residents, now among the lowest in the nation, is a product of an Affordable Care Act that congressional Republicans are seeking to undo.

“More than 20,000 Vermonters are receiving their health care coverage with the benefit of Affordable Care Act subsidies," George said.

Republican Gov. Phil Scott says the fate of those 20,000 Vermonters may hinge on the outcome of the debate in Congress.

“A small change to Medicaid and some of the involvement from the federal government could be devastating for Vermont - hundreds of millions of dollars, tens of thousands of people off from insurance,” Scott says.

Scott says his administration has been reaching out to Republican governors and Republican senators from other states to try to forge a conservative coalition against the repeal and replace movement. He says he “trying to make the argument that this wouldn’t be in the best interest for some of these small states like ours that are so rural and so reliant on Medicaid in particular.”

"It's going to be a major disruption for Vermont health care if that passes." — Todd Moore, CEO of OneCare Vermont

On Tuesday, Scott sent a letter to Senate Majority Leader Mitch McConnell outlining his concerns - he wrote a similar letter to Republican leadership in the U.S. House before it passed its version of the legislation.  Scott wrote in part that the Senate proposal would “leave our state with a budget deficit we could not absorb without cutting health care services for the people who need them the most, or significantly raising taxes on overtaxed Vermonters.”

Mike Fisher is the chief of the Office of the Health Care Advocate, a consumer-protection group funded by the state. The Senate might have delayed its health care vote.

“But they’ll pass something, I believe,” Fisher says.

Fisher says whatever makes it to President Donald Trump’s desk will likely include steep cuts to Medicaid. He says that could mean loss of coverage for thousands of Vermonters.

“It’s absolutely abundantly clear that they won’t get the care they need, and that there’s real impacts,” Fisher says.

Senate Republicans won’t vote on the bill until after the July 4 recess.

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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