Vermont’s path-breaking health care reform project seems headed into daunting terrain that will challenge legislative leaders to find common ground, stay true to their principles and deal with increasingly difficult political and budget realities. “I’m seeing a yellow blinking light,” said state Rep. Sarah Copeland-Hanzas, a Bradford Democrat who supports a so-called single-payer system of universal, publicly funded health insurance. While most Vermonters believe a publicly financed system would be more equitable, Copeland-Hanzas said, they will only support moving forward with reform if they have been persuaded that a viable plan has been developed. But some on the other side of the aisle think the light has already turned red. “Single payer is not a possibility,” said Senate Republican Leader Joe Benning, a Lyndonville resident whose Caledonia Senate district includes several Bradford-area towns. Vermont Gov. Peter Shumlin is due in December to spell out the benefits that would be covered by the Green Mountain Care plan, and in January to present a financing plan for the $2 billion in annual revenue that needs to be raised. An inquiry about the likely timing and content of those proposals elicited this terse email from Shumlin press secretary Scott Coriell: “We’re still on track.” That’s something, given the recent wave of bad budget news from Montpelier, including Wednesday’s announcement of a $17 million round of cuts, which followed last summer’s $31 million reduction in an already-approved budget. Meanwhile, a $100 million budget gap for the fiscal year that starts July 1 still needs to be filled, legislators say. But that budget crunch won’t short-circuit the health care debate, said Copeland-Hanzas, the vice chairwoman of the House Health Care Committee. “To the extent we are (creating) a new way of financing health care, these two issues are not really related,” she said, although the budget pressures “do contribute to the overall sense of unease” in Montpelier. Over the past year, fortune has loosed a hail of political slings and arrows at health care reform in Vermont. The wobbly launch of the $100-million, mostly federal funded, Vermont Health Connect website undermined public confidence in the administration’s ability to carry out health care reform. Despite the website’s improved performance during the current round of applications, for health insurance in 2015, scars remain. Recent revelations of impolitic comments by Jon Gruber, a Massachusetts Institute of Technology professor with a $400,000 contract to assess the economic impact of various taxes to support Green Mountain Care, further depleted the political capital of the governor. That further drained an account diminished by the narrow margin of Shumlin’s November re-election win at the polls (Shumlin topped Pomfret Republican Scott Milne by 2,434 votes, but the victor will be determined by the Legislature in January since neither candidate got a majority). Some critics think it’s time for reformers to roll up their tents and for Vermont to shed its pioneering aspirations. Vermont is too small, too poor and not sufficiently isolated to lead the way, they say. “Vermont can’t do this by itself,” said John McClaughry, a former Republican state senator and vice president of the Ethan Allen Institute, a conservative think tank. McClaughry warned that with universal care in Vermont “the halt and the lame and the cancer stricken (would) come streaming up the Interstate and achieve resident status overnight.” Senate President Pro Tempore John Campbell, D-Quechee, acknowledged that cross-border issues remain a big challenge to reformers. “We can’t just really isolate ourselves,” he said. Also at issue is how the thousands of Vermonters who work in neighboring states and get insurance through employers there would be treated. McClaughry dismissed single-payer advocates as liberals with a “blind faith” that a universal and publicly financed system would “get rid of the insurance companies (and) achieve enormous savings.” Benning held out hopes that if lawmakers could “finally get out of the terminology bind that has got us polarized we might actually be able to do something.” That might clear the way for “some kind of hybrid” system, he said. But that work could best be done at a higher level, Benning said. “If you’re going to have a good program, you do it nationally, not state by state.” Rejecting a popular formulation that describes the states as “laboratories of democracy,” Benning said that the health care debate in Vermont had become a “Petri dish of ideology.” Read more @ vnews/news/14572161-95/legislators-face-serious-headwinds-in-move-to-single-payer
Posted on: Mon, 01 Dec 2014 13:30:28 +0000
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