Shumlin: Green Mountain Care financing options not ready for prime time

Gov. Peter Shumlin announced a three-phase infrastructure investment plan across Chittenden County during a news conference Tuesday at Williston Town Hall. Photo by John Herrick/VTDigger

Gov. Peter Shumlin at a news conference in November. Photo by John Herrick/VTDigger

Gov. Peter Shumlin won’t introduce tax options to pay for a universal health care system this year, despite promising on several occasions that they would be presented to lawmakers before the end of the legislative session.

“We’re not ready, it’s as simple as that,” Shumlin said at a press conference Monday.

Making the transition to universal health care is the most important move to improve job growth and Vermonters’ prosperity in the state’s history, Shumlin said.

“All I’m saying is let’s get this right. That’s more important than meeting some arbitrary deadlines,” he said.

However, all deadlines at this point are self-imposed, because Shumlin missed the statutory requirement to present financing options in January 2013.

Shumlin stressed the complexity of the transition to Green Mountain Care, the state’s planned publicly financed universal health care program, adding that it requires reforming the delivery of health care as well as how it’s paid for.

“This is not like flipping a switch,” Shumlin said several times during the press appearance.

But Republicans have accused Shumlin of playing politics with his financing plans, and said he’s putting off the tax options until after the upcoming election.

“The administration chose to ignore the law’s deadlines, leaving the cynical among us to observe that this is all a political stunt, conveniently spread out over three election cycles,” wrote Senate Minority Leader Joe Benning, R-Caledonia, in a commentary in VTDigger earlier this year.

Republicans have yet to field a serious challenger for Shumlin’s job, but they note that supporting what is widely expected to be the largest tax increase in state history could hurt Democrats in down-ballot races.

Having greater detail on the taxes Shumlin would use to pay for Green Mountain Care could give them more fodder, but it’s also possible not releasing those details could yield plenty of talking points for Republicans as well.

Shumlin may have provided his critics with another one Monday.

Asked if he could name two other options besides the widely discussed payroll tax that could pay for, or help to pay for, universal health care Shumlin said, “Sure, bubble gum and lollipops.”

As recently as Feb. 27, Michael Costa, the administration’s health care financing expert, told lawmakers on the House Ways and Means Committee that he expected they would enumerate financing options in the spring.

Asked in the hallway after delivering his testimony when specifically that would be, Costa said, “I’m not sure, to be candid.”

Shumlin said the decision to delay unveiling the finance options was made over the past several weeks.

“We have a very good business advisory group … that’s helping us to put together a package that will work for Vermonters as well as for businesses,” he said. “As we’ve gotten into the weeds of the various details that need to be ready to lay out a menu of options, there’s pretty broad agreement that we’re just not there yet.”

Shumlin offered a slightly different rationale for the delay last week on Vermont Public Radio.

“I’m saying to my team, ‘don’t spend a lot of time getting committees that won’t even be the same committees working on something that isn’t going to be voted on anyway, and that we don’t have the answers for yet,’” he said during an interview on “Vermont Edition.”

Shumlin was adamant Monday that he didn’t believe waiting to lay out the financing options would set back plans to launch Green Mountain Care.

“We’re going to take the time we need to get it right without slowing down, I hope, the goal of having this done on January 1st, 2017,” he said.

The Legislature has a number of committees looking at all aspects of the transition to Green Mountain Care, and that’s been the case throughout the session, Shumlin said.

But Janet Ancel, D-Calais, who leads one of those committees, said Shumlin’s decision to put off the financing plan might change how she allocates her committee time.

“We’ve spent two to three hours a week on health care all session, and my thinking has been that the more knowledge my committee members have the better,” said the Ways and Means chair. “I think the only thing I need to reassess is if we should keep doing that this session.”

Morgan True

Comments

  1. Walter Cooper :

    I had saved to replace my roof this summer and pour a new floor in my garage. I will hold off now. We are neither land-wealthy Boomers nor Trustafarians, but we make a decent living–all from sources out of state. Sadly, I am preparing to sell. A forty year old with two kids in local schools. Vermont doesn’t want or understand a middle class.

  2. Michael Stahler :

    Two points: first, the Gov is breaking the law and NOBODY seems to care. He was supposed to outline how to pay for it over a year ago AFTER THAT election. Second, he only reason why he is holding off is that this is an election year. Might as well call a spade a spade.

    And his flip answer only shows that he is not taking the gravity of the policy change seriously.

  3. Vermonters for Health Care Freedom has been trying to hold Gov. Shumlin accountable for a finance plan and we were the first to expose this last January when he and Secretary Spaulding failed to follow the law (Act 48) then. The Governor has been legislating from the 5th floor and it’s time for Vermonters to rise up and hold Shumlin and the legislature accountable or scrap this health care scam.

  4. Dave Bellini :

    The Governor has become too cocky about this. He doesn’t think ethics apply to him, he ignores the laws he sponsors and his word has become meaningless. He reminds me of the old movie character: “Lonesome Rhodes” from the movie: Face In A Crowd played by Andy Griffith. All he needs is a guitar……….

  5. Stan Hopson :

    The Governor is channeling his inner Harry Reid. Just last week the Senate Majority leader from Nevada stated on the floor of his chamber “all those Obamacare horror stories are lies”.

    Leadership is not ignoring the woes of others, especially unwarranted pain and suffering like many Vermonters have had to endure during the rollout and after with sub par and more expensive coverage. The Governor and his legislative allies can cling to the feel good stories of a few uninsured in better position now, but the aggregate population isn’t better off today then before Shumlin was elected.

    Not being forthright with a financing plan after three election cycles is borderline criminal. The inability of this administration to show their cards is making the decision all the much easier for those intent on leaving VT or not growing their business.

    Vermonters are being held captive at this point in a never ending groundhog day of financial malfeasance.

  6. Kathy Callaghan :

    This reminds me of Lucy in Peanuts who keeps holding the football and then pulling it out from under the kicker at the last minute. The footbball is single payer financing, we Vermonters are the kicker and Shumlin is Lucy.

    With both Vermont Health Connect and single payer, I find myself wavering between “This is a man who truly doesn’t know what he’s doing” and “He knows but he thinks he’s the only one who needs to know”.

    The first one is scary, but the second one is even scarier.

    • Walter Carpenter :

      “The first one is scary, but the second one is even scarier.”

      What if he is right and the finances do need that long to simply sort out from the medley of confusion they are now into something resembling sanity and a system?

      • Jim Barrett :

        What if???? No laws should be passed when no one has a clue as to costs and where the money is to come from!

        • Peter Liston :

          I’m sure that you were against the war on Iraq for the same reason.

  7. Craig Powers :

    Take your marbles and go home….

  8. Jamie Carter :

    “However, all deadlines at this point are self-imposed, because Shumlin missed the statutory requirement to present financing options in January 2013.”

    As noted, Shumlin is in violation of a duly passed and enacted state statute making him a state criminal and subject to impeachment by the House. Impeachment should be beyond politics and while this “crime” may not warrant removal from office, it is the duty of the House to impeach the Governor for his crime against the state and allow the Senate to determine his punishment.

    Paging Don Turner and Shap Smith….

  9. Ralph Colin :

    First he paid 300 grand to Dr. Hsu of Harvard to develop a plan for Green Mountain Care. With the Doctor’s financing suggestions obviously unworkable, Dr. Slick then paid another 300 grand to UMass , Amherst to get around Hsu’s offering. The guys from Amherst said it would cost around $1.6B, an apparent lowball figure, and they were told NOT to release a financing plan which they were also supposed to publicize because when he saw what they had to say, he began to feel a dampness in his undershorts.

    Wendy Wilton, who received no funds from the state government, predicted it would cost between $1.8B and $$21B. Shummy began to feel a tummy ache. So in January 2013, he announced that he was forming a committee of about twenty of his closest buddies to review everything and promised they would come up with a workable financing solution in three or four months. We never heard from them and wonder if Shummy quashed their scheme as he did with the UMass plan if, indeed, they ever delivered one. Then another independent consultant announced that the miraculous single-payer proposal could come in as high as $2.2B per year, but Gov. Sleeze ignored that one too; he was feeling the pressure of 24-hour gas pains. More recently he hired another accounting genius to be on the Vermont payroll and to perform the magic he wants staged. Sounds like that’s additional failure.

    So now, after more than two years of this nonsense, he complains that this is not an easy task and that the assignment shouldn’t be rushed. Imagine that! No, we should now be content to wait until January 2017 , a little less than three full years from now, when his brilliant health care plane is due to fly. And in the process, two more election cycles will have come and gone.

    So, suckers, are you all willing to wait for this crap to continue? Or is it about time we told Dr. Slick to take a hike? How long are you willing to swallow his lies. He’s just stringing us all along in the hope that we’ll fall for his strategem of heisting another reelection with his promises of more free lunch at our expense. We shouldn’t even wait until November. He should resign now or be impeached!

    • Jim Barrett :

      I totally agree with you and you put the story in a nice context. Until we march seriously on Montpelier!

  10. Stan Hopson :

    Until you get 5000 people camping out on the Capitol steps for days protesting, our Governor and his crony legislators will keep obfuscating, bobbing and weaving and the press will just do the arbitrary “wow, still no financing plan huh? story and move on to a smaller dumpster fire.

    These people need to feel the heat, until then you get what you elected people.

  11. Gail Graham :

    As I have been saying for a long time now, the only difference bet. Shumlin and OB, is government status, esp. with the HC debacle they have managed to screw up, both Federally and for the State of Vt. I don’t think either one of them has a clue how they are going to dig their way out it. They have both cost us (tax payers) more $$ than we will ever really know.

  12. The picture says it all. Poor fellow. His hair isn’t even combed.

    What would be the political cost to Gov. Shumlin if he simply admitted defeat?

    At this point, throwing in the towel and walking away may be of some personal benefit.

  13. David Dempsey :

    If Phil Scott doesn’t run for governor, the Republicans might as well let Shumlin win and then sit back a watch the Shumlin Administration collapse and burn.

  14. Devastating Diagnosis – Green Mountain Care 2017
    a prognosis by H. Brooke Paige

    Vermont (January 2017) – Peter Shumlin’s socialist dreams of “universal, single payer healthcare” have mutated into a nightmare over the past five years. The utopian dream of healthcare for all was never properly explained nor fully understood by Vermonters. The working poor thought that it would be the “free care” that they saw those on welfare receiving. Most believed the promises that their healthcare providers and the level of care they were receiving would somehow continue – while the cost of care would be greatly reduced through streamlining and controls that the state and federal government would impose. Those who worked for large employers and government believed they would not be affected. None of these assumptions would prove to be correct.

    Green Mountain Care (GMC) quickly acquired the resources of Vermont Blue Cross and Blue Shield (BCBS) as most of its insured became GMC clients. In the early days of the rollout, GMC and its promotional website Vermont Health Connect (VHC) failed to deliver healthcare for the small group of self-insured and the employees of small businesses targeted as the first clients of GMC. Governor Shumlin and his loyal minions on the Health Care Board, lead by a Burlington restaurateur, had no understanding of the healthcare insurance industry and were unprepared to handle even the most modest problems as they arose. While the Federal Government abandoned their hapless website contractor CGI-FEDERAL, Shumlin regrettably decided to continue with them “throwing good money after bad” eventually spending over $100 million of state and federal funds with CGI on a system that was politely described as “leaving a lot to the imagination” of the users. The plain truth was that the CGI system would never work – despite months of “tinkering” and additional monies wasted, the VHC website never reliably allowed users to: create accounts or access them, employers to edit or update their accounts (if they had been patient and creative enough to create one) nor could the system collect premiums and in the end could not pay for health care services incurred by its “insured” clients. In the end CGI was abandoned and the BCBS operating system, by default, became the GMC system.

    Vermonter’s healthcare system is an unrecognizable husk of the quality network they enjoyed just a few years ago as the politician’s grand scheme, GMC, has decimated Vermont’s hospitals and healthcare practitioners – as well as the state’s economy at large. It is sad that there was no way, back in 2012, to foresee the full consequences that the progressive plans, designed by inexperienced, insistent social architects with big ideas but no understanding of the complexity of the healthcare system or the health insurance industry that financed it.

    As the GMC system sputtered to life in 2014, many providers chose not to participate as a result of the anemic 105% of Medicare reimbursement rates which barely covered their out of pocket costs and failed to contribute toward overhead or capital investment costs. Within a year 20% of practicing physicians and specialist had retired, moved out-of-state or decided to limit themselves to “fee for service” patients. Nearly 50% of Vermont’s Oncologist and Cardiologist declined to participate in the GMC program. To fill the void, the Vermont Legislature hastily authorized nurse practitioners and LPNs to act as primary care providers without direct supervision.

    Today, Vermonters receive their healthcare treatment and pay for services in ways unimaginable just a few years ago. For GMC participants who have their treatment denied by the GMC Review Board and those who have decided to pay the penalties instead of participating have found that many providers offer deep discounts for cash payment for services rendered. There are now many “fee for service” care facilities including: MedExpress, UrgentCare, Got-A-Doc, LabCorp, and Dynamic Therapy that offer extensive portfolios of services for walk-in patients on a first-come-first-served basis. Patients pay for services when rendered by cash or credit card with financing arrangements available for more extensive and costly procedures. While these new facilities, at first blush, seem questionable; most are staffed by highly competent and experienced practitioners (many are those that chose not to participate in GMC) and provide quality care. For those on a budget or in a hurry, Doctors on Call provides internet and phone consultations on routine and minor medical concerns, allowing many to resolve their medical issue on their own. Additionally, there are “premium” service providers like Concierge Medical which handle all the details for the medical needs of the wealthy – lining up the best doctors, treatment facilities and even arrange transportation before and after treatment, truly door-to-door service.

    Possibly the most destructive aspect of the Green Mountain Care program has been the state’s scheme for financing its ever escalating costs. Governor Shumlin, for several years, obfuscated and then flatly refused to reveal the amount and sources of the funds required to finance GMC’s operation until well after his reelection in the fall of 2014. That December, the Governor finally revealed the three-pronged taxation plan required to generate the $2.9 billion necessary to fund GMC – including: 1 – a 25% payroll tax with employers paying 17.5% and employees having 7.5% deducted from their paychecks (the self-employed are required to pay the entire 25%), 2 – a 10% tax on all unearned income – capped at $200,000 per year and 3 – an increased healthcare claims tax raised from 7% to 14% – this tax, formerly paid by insurance firms, is now paid by the patients receiving the care. As soon as the Governor had announced the requirements of the “GMC taxes”, employers implemented plans to “scale back” their Vermont operations or leave the state in order to remain profitable. By summer of 2016; new layoffs in Vermont totaled over 15,000, including nearly a thousand from the healthcare industry as they scaled back in anticipation of reduced revenues from GMC.
    Hospitals and medical providers, desperate for additional revenues, began to increase fees for services rendered in patient categories not covered by GMC, primarily: workman’s compensation injuries, auto accident victims and personal injuries paid for by liability insurance claims. Insurance providers immediately adjusted their rates to their insured by as much as 25%, worsening Vermont’s economic and business environment.

    Vermont’s healthcare subsidies encouraged many lower wage earners to quit their jobs and sign-up for the broad spectrum of available social service benefits, since the new healthcare taxes in addition to state, federal and Social Security taxes resulted in significantly lower take home pay, insufficient to cover their living expenses.

    Former Governor Shumlin had narrowly won reelection in 2014, in part because the impact of his Green Mountain Care and his ultimate prize of “single payer” were not fully understood. By 2016, Shumlin had realized that he had little chance of winning another gubernatorial race and attempted to best incumbent Senator Patrick Leahy in the Democratic Primary – failing by a wide 3:1 margin.

    Ever the opportunists, Shumlin and his brother, Jeffery, refocused their Putney Travel Service to take advantage of increased interest in “medical vacations” brought on by healthcare treatment delays and denials by GMC. Putney Medical Vacations will soon provide complete packages that allow their wealthy customers to avoid the delays and the reduced quality of care in Vermont by arranging treatment “stays” in exotic venues that include: Bermuda, Costa Rica, Bangkok, Mexico and Cape Town where patients can save up to 70% under the expert care of orthopedic, oncological, plastic or general practice surgeons and enjoy recovering on the sun-soaked beaches of the treatment venue.

    Governor Scott and the newly elected Republican Legislature are struggling with the consequences of GMC. Vermonters who cannot afford to avail themselves of “fee for services” treatment find long waits at the “public” hospitals – the state has been required to take over the operation of most of the formerly independent institutions, closing several smaller hospitals to control costs. Appointments for non-emergency hospital procedures now require waits of three to five months once they are approved by the GMC Board.

    All of this could have been easily avoided. The initial concern over 40,000 uninsured Vermonters was discovered to be a gross exaggeration. When those who wished not to be insured (primarily the wealthy and young individuals) and those who chose to find care through social services (at the taxpayer’s expense) were eliminated from the equation , the actual number of uninsured individuals who wanted insurance coverage was less than 9,000. The biggest problem was that none of those involved in the planning of GMC had a thorough understanding of healthcare insurance or the financial tightrope that these firms walked to successfully balance the costs of care and premium rates while managing to remain financially viable. The “public financed” political/government alternative has proved to be a disaster of biblical proportions – out-of-control costs and radically insufficient care.

    It is a shame that there is no way to reach back in time and inform Vermonters of the healthcare troubles in their future.

    H. Brooke Paige, a historian and writer, is a resident of Washington, Vermont.

    Devastating Diagnosis – Green Mountain Care 2017 as published in the WORLD, March 12, 2014

    • Bill Gardyne :

      Your future vision is a very clear window into a quite possible outcome of our Governor’s current path to single payer health. Hopefully some of the more rational Dems will see this handwriting on the wall and back off their support before it’s too late. VT is not a Country and it doesn’t print it’s own money.

    • eric adler :

      I just heard Brook Paige running down single payer health care on VPR’s Vermont Edition. I didn’t get to ask him my question: The Commonwealth Fund surveyed health care provided by 11 industrialized countries between 2003 and 2014.
      http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror The US came in at number 11 every time. They looked at cost, access, wait times, effectiveness of treatment and health of the population. Britain, with a single payer system, came in at number one and cost $3,056 annually per person, with the US most expensive at $8,503. The average cost for each doctor of dealing with insurance companies in the US is $83,000.

      Why does Mr. Paige claim that the costs and outcomes of single payer systems would be such a problem?

  15. rosemarie jackowski :

    There are still too many unanswered questions. The president said that if you liked your doctor you could keep him. We now see how that is working out.

    The other big question is: “If you like your house can you keep it”. What is Vermont doing to answer that question? Who is in charge? Where should Vermonters go for answers?

    Maybe Washington will save us….or maybe not. This is not going to end well.

    Please see:
    http://www.usatoday.com/story/news/nation/2014/03/10/medicaid-enrollees-billed-at-death/6262707/

    • Rosemary, I have looked into what you just wrote, and apparently, in most of the 23 Obamacare Medicaid expansion states, of which Vermont is one, the estates of people aged 55 to 64 can have assets seized to pay back Medicaid expenses those individuals incurred during that time, after their death.

      It’s unclear whether this is just for long-term care, for actual expenses incurred, or for a per-capita levy even if you never got care under your Medicaid plan. (A couple of states in the Northwest have gotten rid of this aspect of Obamacare because folks with significant assets were declining to sign up for Medicaid.)

      Farmers frequently get injured, have heart attacks, and need rehab for long-term disability. This law may spell the end of some intergenerational family farms in Vermont.

      • rosemarie jackowski :

        Ellin…Yes. It is very complicated. I have been in communication with some legislators. They tell me that Vermont is not presently doing the ‘claw-back’ on some Medicaid expenses today. What about tomorrow? We need a firm policy – a commitment BEFORE anyone signs up. We are waiting. We are at risk. We need information. We need an open public discussion. We need to protect family farms and family homes, even from long term care ‘claw-back’.

        Like I keep saying – we need dental, vision, and long term care in any health care plan.

        Please see:
        http://www.countercurrents.org/jackowski070314.htm

  16. Matt Fisken :

    Maybe Gov. Shumlin was serious and meant that we should tax the heck out of bubblegum and lollipops. It’s plain as day that non-nutritive “foods” including soda are causing many of the chronic health problems that so heavily burden our healthcare system.

    Let’s just put a 100% tax on gum, candy and soda and stop fretting over how it would hurt all the mom and pop stores or be “regressive.” Sugar is hurting us all, even the people who abstain because their health care premiums are much higher than the benefits they get from having insurance.

    And while we’re at it, let’s make candy and soda ineligible to buy with food stamps.

  17. Lee Stirling :

    With his snarky “bubble gum and lollipops” reply, Governor Shumlin essentially tells those seeking answers to go ____ themselves (insert 4-letter word). Nice Gov. Nice.

  18. Jim Barrett :

    This is again a government sham that was voted for and signed onff by Shumlin without having a clue as to how much this would cost. Every representative who voted for this socilaized insurance program and Shumlin should be held accountable and there is now proof that they ignored looking at costs and who would pay for this mess. We have lapdogs in the legislature who are obviously more worried about where lunch will be held to know or care about costs. We are being victimized by not knowing how and who is going to pay for this ripoff. A march on the state capitol is in order to repeal this bogus law and demand accountability.

  19. Paul Lorenzini :

    Please, do not run for governor, if you do not support this philosophy. Let Shumillionaires own the results of their decisions. We must not attempt to float their boat, the are the captains and should sink with the ship they built.

    • Paul Lorenzini :

      I actually feel a little sympathy for the governor, he is under a lot of pressure from the friends he chose, and I believe he is starting to see the folly of their ways. Big ideas that necessitate the confiscation of others wealth in order to enact them. It won’t work, and I think all the delays are a reflection of truth that between the takers, the ones in power and the ones considered needy, there is a free minded people that will not allow the tyranny necessary to enact a progressive socialist agenda. Who are the greedy ones? Is it those that want to keep what they have, to distribute freely to whom they see fit, or is it those that wish to distribute others belongings to their perceived friends/potential voters, by power of law?

    • Ellen Fiske :

      I am worried that if we try to let Shumlin and his cronies go down with their own ship (by voting them into office again), we will get more bills like school board consolidation, police tasing people willy nilly, expedited non-emergency forced psychiatric medicating, and on and on and on and then we will have a lot of work to do just to dig out of it. This paying for the single payer mess isn’t even the worst part of what Shumlin has been up to. We need a new governor, and not a Democrat. I don’t care whether it’s a Republican, Independent, Progressive, Liberty Union, Green, or whatever other party. I would vote for the neighborhood cat before I would vote for Shumlin. His friends influenced him badly, I think that’s true, but he’s still responsible. He’s an adult, not a 12 year old. By the way I voted for Shumlin. I am so ashamed. I apologize.

  20. Mike Dunbar :

    Shumlin’s flip response to a very important question that will impact us all is a very clear indicator of what kind of man he is. You can tell he grew up milking the family business.

Comments

*

Comment policy Privacy policy
Thanks for reporting an error with the story, "Shumlin: Green Mountain Care financing options not ready for prime ti..."