File: Governor Peter Shumlin. Photo by Josh Larkin
President Barack Obama told the National Governors Association on Monday that he supports waivers for states that want the flexibility to pursue new health care programs.
The announcement could pave the way for congressional approval of changes to the health care reform law enacted last year.
Vermont’s Democratic Gov. Peter Shumlin was elated by the news, which he said would make it possible for Vermont to more effectively pursue a plan for a single-payer health care system. Shumlin, who took office in January, has made single-payer his No. 1 initiative.
The White House endorsed a bill, the bipartisan “Empowering States to Innovate Act,” which would enable states to obtain “state innovation waivers” in 2014. Under current law, the waivers aren’t available until 2017.
The president’s announcement was made on the last day of the association’s meeting. Shumlin, whose comments on collective bargaining and the U.S House budget cuts made news on a D.C. political website, said Obama wants to give states flexibility so that they can be the “laboratories for universal access and cost containment” in 2014.
“Without that, we can’t pass a single-payer system that contains costs,” Shumlin said. “I told the president one of our biggest challenges is double-digit health insurance increases. It’s a jobs killer. If we have to wait until 2017 to get costs under control, we’re dead in the water – we can’t create jobs.”
Shumlin said he sat next to the Republican governor of Utah, Gary Herbert, who wanted the same kind of flexibility, but for different reasons. (Herbert recently called the federal law, which ends discrimination against patients with pre-existing conditions, “an unfunded mandate.”)
Link to information about the Federal health care law
Vermont’s congressional delegation embraced the news that Obama threw his support behind legislation that will enable states to have more flexibility under the Affordable Care Act. Sens. Patrick Leahy and Bernie Sanders and Rep. Peter Welch all supported an amendment introduced last month that had a similar thrust.
In a statement, Democrat Leahy said: “This is a wise decision that keeps in focus the goal of continually improving health care in America. I applaud President Obama and Secretary Sebelius for supporting efforts by Vermont and other states to go above and beyond what the Affordable Care Act requires. They know that the federal government does not have a monopoly on good ideas, and innovations by the states will prove – and improve — the benefits of health insurance reform, on the ground and in practice.”
In a joint press release, Sanders, an independent, said: “At a time when 50 million Americans lack health insurance, and when the cost of healthcare continues to soar, it is my strong hope that Vermont will lead the nation in a new direction through a Medicare-for-all, single-payer approach.”
“This legislation will give Vermont a green light to lead the nation in providing quality health care at a lower cost,” Welch, a Democrat, said.
The waiver legislation is still wending its way through Congress, but the support from Obama is key, an aide to the delegation said.
Anya Rader Wallack, special assistant to Gov. Shumlin on health care reform, said “It’s wonderful news. We still have to pass legislation to have this have an effect, but having the president’s support is tremendously helpful. If it means ultimately we’re able to get legislation through, we can as a state begin planning immediately and talk with the feds about a system in Vermont that doesn’t have to adhere to all the requirements of the Affordable Care Act.”
Michele Obama and Becca Shumlin at a Washington D.C. event. Photo courtesy of Gov. Shumlin.
Shumlin was in Washington, D.C., for three days of meetings with other governors, the president and members of the congressional delegation.
Shumlin kicked off his visit with a keynote address to the Pew Center on Global Climate Change. Over the weekend, he met with members of President Barack Obama’s Cabinet, other White House officials and Vice President Joe Biden. On Sunday, he met with the premier of New Brunswick and participated in special meetings with governors from the Northeast and New England.
While Shumlin was at the Capitol, he had an interview with Politico.com in which he denounced the U.S. House proposal to cut appropriations for key human services programs in fiscal year 2011 that he said could jeopardize the lives of poor Vermonters. Funding for Low-Income Heat Assistance Program, Head Start, Planned Parenthood and Community Services Block Grants would all take a hard hit under the budget plans. A myriad of other programs are also under the knife, including child care subsidies, community policing programs and the Environmental Protection Agency.
Congress is deadlocked on the interim spending bill for fiscal year 2011.
If Republicans and Democrats can’t agree on a measure soon, the nation faces a government shutdown.
Shumlin told Politico.com: “You start cutting our [Low-Income Heat Assistance Program] funding in half, Vermonters freeze in their homes. We’re a cold state.”
At a press conference last week, Shumlin said the cuts make his job of balancing the state’s budget, which includes a $176 million revenue gap, even more difficult.
Read Shumlin’s NGA letter, Page 1
Read Shumlin’s NGA letter, Page 2
Shumlin also reprised his role as chief booster for local unions in D.C. He was the only governor at the NGA who addressed a group of union protesters near the hotel where the NGA winter meeting was held.
The Hill.com reported that Shumlin told the crowd: “I just want to say that not all governors are one and the same. In Vermont, we know that we have more success with maple sugar than we do with vinegar.”
In an interview, Shumlin said he had productive talks with Ray LaHood, secretary of transportation, who supports Vermont’s effort to develop high-speed rail from Vermont to Montreal (with a spur to Boston). He also talked with Arne Duncan, secretary of education, about federal funding for early childhood education.
The event was capped off with a meeting with President Obama and First Lady Michelle Obama and a performance by Gladys Knight.
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Thank you, Digger, for getting the story right. Unlike coverage in other media, you make it clear this is only one of the many needed waivers to institute a single payer.
I’m still trying to figure out, though, whether the type of Exchange envisioned in H. 202 could be given a waiver, as the waivers are described in the federal law, and in the White House fact sheet on the amendment. The fact sheet provides examples of possible waivers, and they appear to increase choice — e.g. state could offer more plan designs, state could allow larger employers the option of buying coverage in the Exchange. The plan in Vermont’s H. 202, on the other hand, is to narrow choice to ONLY what is available in the Exchange (no plans can be sold outside the Exchange), and to have only one carrier’s plan for sale in the Exchange. Effectively, the Exchange would be the only place any individual or employer with fewer than 100 employees could find coverage.
If all of our eggs are in that basket, the coverage had better be very affordable, the subsidies had better be sustainable, and the physician/hospital networks had better be ready. Otherwise,our plan wouldn’t meet the waiver’s test of ensuring that as many people are covered, at the same or lower cost, than what would happen under the existing (unwaivered) federal law.
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Obama’s support of Affordable Care Act state waivers is great news. Although the US Supreme Court may review the legality of the ACA, it is not likely that the powerful and omniscient Health Insurance corporations will allow the ACA to be aborted. Why would they want that action when the ACA, as it stands, would require every American to buy an expensive, profit-driven health industry insurance plan. Here in Vermont, we have the opportunity to finally overcome the machinations of the Wall St driven health insurance corporations and implement a cost containing and universal system of health care for all Vermonters. With the state waivers available, hopefully, in 2014, the Vermont legislature can pass the single payer bill and create the needed infrastructure for implementation by 2014. Without this waiver, the state would have to wait six more years: six more years of damage from the health insurance industries.
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As I understand it, this announcement is hardly worthy of being called anything new, apart from the political opportunity to make it look as though something has changed to make Shumlin’s plan more plausible.
Obama has supported this from the start (“news”: he still does), but it wasn’t in the Affordable Care Act as passed (“news”: the law hasn’t changed.) There’s a bill we already knew was introduced to move the date for waiver applications earlier, and it still faces getting through the House and Senate. If Obama’s statements that he supports this bill gives it important new momentum, that would be a surprising change, since an earlier waiver date was rejected by a Democratic Congress. His support will now be “tremendously helpful” in swaying the new Republican House majority? Hmmm, now there’s a political spin.
What I haven’t seen much coverage of is the testimony of our (nonpartisan) Legislative Joint Fiscal Office last week, stating that the plan would probably save money in its first few years, but then fall back into an upward spiral that would require increased revenue or decreased benefits. That makes the governor’s enthusiam about saving costs and enabling new job creation ring a bit hollow.
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Lady Thatcher was prescient when she said: “The problem with socialism is that eventually you run out of other people’s money.”
Having ALL Vermonters in a single payer system would create the greatest savings. Any single payer system must include all people on a government payroll; state, county and town. That way all Vermonters have the same plans and the same services. That would be democracy and fairness. All treated equally before the law. No big host of people would be required to administer it.
Plans with high deductibles should also be offered to people who want them.
It would be the lowest cost way to go, the least complex and the easiest to administer, AND create the greatest savings. That is the way it is done in Europe.
I lived in Europe for 28 years under a single-payer system that covered ALL workers, including government workers, professors in colleges, policemen, teachers, loggers, farmers, business owners, etc.
It is a fair system that provides care for all at about half the cost per person per year.
Medicaid and Medicare have 10% administrative costs and 90% benefits.
HMOs have 20% administrative costs and 80% benefits.
The additional 10% HMOs keep is about $200 billion per year which is used for lavish offices and multimillion dollar paychecks for top management.
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“The problem with socialism is that eventually you run out of other people’s money.”
As does Capitalism when there is no more left to take:) Thatcher conveniently forgot about that one:)
William, thanks for the stats on the percentages paid on health care versus administration in the HMO’s and on medicare. Where did you live in Europe for so long? How did you like the health systems there? I lived in israel for a while, a long time ago, and, though I did not have much occasion to utilize it, found the health system there pretty good. Everyone was covered; no rejections, denials, and no one was left out of it because of economic reasons like here.
“As I understand it, this announcement is hardly worthy of being called anything new, apart from the political opportunity to make it look as though something has changed to make Shumlin’s plan more plausible.”
As I understand it this announcement, while perhaps not new, is Obama officially coming out into the open with his support and giving his blessing to it if the particular state’s endeavor meets the criteria of the affordable care act — which Shumlin’s plan certainly does. This is clearing another hurdle to making it a reality.