As the recently-formed Green Mountain Care Board begins its serious work of reforming health care in Vermont, lawmakers want to make sure its work remains untainted by politics.
Just how much distance the new board can maintain from the Shumlin administration is unclear. The board discussed its work thus far with the House Committee on Health Care Wednesday. The five-member board was appointed by Gov. Peter Shumlin in September. Before that, Anya Rader Wallack, the board’s chair, spearheaded a campaign to pass Act 48, the new law that puts the state on the path toward universal health care.
Administrators have compared the board to the quasi-judicial Public Service Board, but its role is somewhat more opaque.
The board discussed its progress with the House Committee on Health Care Wednesday and its plans during the legislative session. On Jan. 15, the board will produce a work plan to implement its duties under the act.
While the board has been entrenched with the administration, its offices are in the Department of Banking, Insurance, Securities and Health Care Administration, lawmakers expressed concerns the relationship might be a little too tight.
Rep. Paul Poirier, I-Barre City, a member of the health care committee and staunch supporter of health care reform, brought up the issue.
“My concern is autonomy,” Poirier said.
Poirier asked if there will be a wall of separation between the Shumlin administration the the board.
Not quite, said Wallack. While the board may be more of an independent entity in the future, at this point it still needs support from the administration, according to Wallack. The board is adding 18 new employees, nine of whom are coming from BISHCA as support staff, so it may be able to stand on its own eventually, but for the time being, it will remain at least to some extent under the wing of the Shumlin administration. The board also plans to use the federally-mandated health benefits exchange as a stepping stone for a universal health care system in 2017. The Department of Vermont Health Access will develop the exchange.
Rep. George Till, D-Jericho, who sits on the committee, hinted that the legitimacy of the board’s decisions may hinge on how much it can distance itself from the politics of the Shumlin administration.
Till said he wanted to stress the importance of independent decision making. At a meeting earlier in the week, Till said he continued to be concerned by the fact that a November study on the costs of the state’s health care system came from the administration and the Legislative Joint Fiscal Office rather than the non-partisan JFO alone.
Poirier pushed the board on the funding mechanism for the single-payer initiative.
“The biggest criticism I’m hearing is you’re punting on the financing,” Poirier said.
Under Act 48, a financing plan is not due until after the 2012 election. Conservatives have repeatedly criticized the Shumlin administration for waiting until after the election to come out with financing for the universal health care plan.
Dr. Allan Ramsay, one of the board’s members, defended the financing plan timeframe given the complicated nature of the existing system.
“You can’t just flip a switch from fee-for-service to a value-based compensation system,” he said.
Poirier said he understands the complexities, but the public has a difficult time figuring out why this takes so long.
“My concern is the guy that’s working in the factory,” he said.
