The Shumlin administration’s so-called single payer financing plan is under attack for allegedly failing to comply with its statutory purpose: providing a plan to finance the publicly funded health care system known as Green Mountain Care.
On Thursday, the Republican House Caucus sent Secretary of Administration Jeb Spaulding a formal request to comply with the requirements of Act 48 within 15 days.
Act 48 is the law that set Vermont on track to create a single payer system. It requires the Secretary of Administration to submit a plan that “shall recommend amounts and necessary mechanisms to finance Green Mountain Care” by Jan. 15, 2013.
At a bipartisan — albeit Republican dominated — press conference on Thursday, legislators said the document did not meet this requirement, among others.
Rep. Cynthia Browning, D-Arlington, has a PhD in economics and told reporters that the administration is sidestepping the most difficult element of the system: how to pay for it.
“The financing is the hardest part,” she said. “If you cannot come clean and be honest about how the program might be financed, even if it won’t come into effect until 2017, … it makes me wonder how serious you are about doing the program.”
“The governor and the administration are not above the law,” Browning added. “They need to provide us with all of the information in Act 48.”
In 2011, the Shumlin administration expressed hope that Congress would allow for waivers to deviate from the Affordable Care Act by 2014. Congress did not change the ACA requirement, so the earliest the state can receive a waiver to create a single payer system is 2017. The Shumlin administration has repeatedly said the state needs to focus on implementing the health benefit exchange, which will become the primary health insurance marketplace for Vermonters come 2014, before focusing on financing single payer.
Robin Lunge, Shumlin’s director of Health Care Reform, said the administration would announce a path forward for creating and discussing specific financing mechanisms on Feb. 15. She also pointed out that much has changed since Act 48 was approved in 2011.
“We provided the two financing plans as required by Act 48, Section 9, and believe we’ve complied with the legislative request for information,” she said. “We do believe there is work to be done moving forward before narrowing down specific financing plans and we have time to do that. When Act 48 passed, the presumption was that we were moving towards a single payer financing plan in 2014.
“We have time to really have a robust conversation with Vermonters and not lock ourselves into a financing plan four years ahead of time,” she said.
But many legislators and anti-single payer advocates question whether the administration is taking the public for a ride.
Jeff Wennberg, director of anti-single payer group Vermonters for Health Care Freedom, alleged that the administration failed to meet 15 requirements of the law, ranging from missing the deadline to the absence of many required tax analyses and the lack of any specific financing mechanisms to publicly fund the system.
“The information that is missing from the report is critical to an informed debate within the general assembly on required new taxes, a magnitude of which dwarfs all prior revenue discussions in the history of Vermont,” he said, referencing the $1.61 billion sum that the report projects such a system would cost taxpayers.
GOP minority Leader Don Turner said this is not an ideological matter, but a legal one.
“This is not a debate about the law,” he said. “This is simply complying with the law that was passed by this body in the last biennium. You have to comply with the law, I have to comply with the law, the Ggovernor and his administration should have to comply with the law.”
“If the administration doesn’t comply with the law, why should Vermonters?”
For more on the single payer plan, read VTDigger’s redux: http://vtdigger.org/2013/01/29/redux-report-calls-for-1-6-billion-in-taxes-doesnt-include-recommendation-for-financing-single-payer/.
Rep. Don Turner’s letter to Secretary of Administration Jeb Spaulding follows.
January 31, 2013
Dear Secretary Spaulding:
I write on behalf of the Republican Caucus of the House of Representatives. As you know, many members of our caucus voted against what is now Act 48, but that is history. Our concern now is how that Act will move forward.
Act 48 itself laid out a plan—a roadmap if you will—for advancing Vermont’s health care reform efforts. It is the law, and it should be complied with.
Our review of the University of Massachusetts report reveals that it falls far short of complying with the requirements of Sec. 9 of Act 48.
The act requires the secretary of administration or designee to recommend two financing plans to the legislative committees of jurisdiction by January 15, 2013, one to recommend financing amounts and mechanisms that must be in place by January 1, 2014, and the other to recommend the amounts and mechanisms necessary for Green Mountain Care, as well as issues related to individuals who live or work in neighboring states. Both plans are also required to address several financing-related issues, including potential financing sources, funding needs, and financing mechanisms. The act requires you or your designee to consult with interested stakeholders to determine the potential impact of various financing sources on Vermont businesses and on the state’s economy and economic climate, and to report these findings and any related recommendations. It further requires you or your designee to solicit public input when designing the financing plan for Green Mountain Care, to provide opportunities for public engagement, and to consider strategies to address individuals who currently receive health coverage through federal governmental or foreign sources.
You chose to contract these responsibilities out to people at the University of Massachusetts (your “designee”?) at a cost of $300,000.00. In our view, the UMass report fails to provide the information and recommendations required by the Act.
We understand that your view is that a single payer system cannot begin before 2017 and that the General Assembly does not need to take any action this year. We respect your right to hold that opinion, but the General Assembly may not agree, and should the General Assembly wish to take certain actions to further Vermont’s health care reform efforts this year, we are tremendously handicapped by the lack of information and recommendations contemplated and required by Sec. 9 of Act 48.
We would respectfully request that you comply fully with the requirements of Sec. 9 of Act 48 within 15 days from your receipt of this letter.
Sincerely,
Don Turner Jr. House Minority Leader
