Health Care

Health care reform bill stirs debate about governor’s financing plan; Browning sues administration over financing plan

Rep. Cynthia Browning confers with a colleague. Photo by Taylor Dobbs
Rep. Cynthia Browning confers with a colleague in a previous biennium. File photo by Taylor Dobbs/VTDigger
The House of Representatives gave preliminary approval to a wide-ranging health care bill that supporters say positions the Legislature to pass laws during the next session that will underpin Vermont’s planned universal health care program.

A debate on the House floor late Wednesday hinged on a provision to compel Gov. Peter Shumlin’s administration to deliver a financing plan for Green Mountain Care, as the program is known.

The administration’s financing plan has become a flashpoint for concerns about the potential fallout from the state’s transformative effort to pay for health care through taxes instead of private premiums.

Shumlin’s decision earlier this year to delay presenting a financing plan to lawmakers rankled Republicans and pained some members of his own party; perhaps none more than Rep. Cynthia Browning, D-Arlington, who filed suit in Washington County Superior Court this week to obtain records relating to the administration’s work thus far developing its financing proposal.

The suit comes after the administration rejected Browning’s public records request for documents relating to the plan, invoking its executive privilege.

“The Legislature is a branch of government and we deserve to be part of the process,” Browning said.

Supporters and skeptics alike should be demanding to see the administration’s work on a financing plan for Green Mountain Care in the interest of transparency and so the work can begin to be vetted, she said.

“Our concern is that we get the best proposal, not that we get the earliest proposal,” said Rep. Janet Ancel, D-Calais, chair of House Ways and Means. Reviewing an incomplete plan would not be a good use of legislators’ time, she said.

The bill, S.252, requires the Shumlin administration to produce a financing plan by January 2015. If it doesn’t do so, the remaining state planning and implementation funds will be frozen until the financing proposal is made available.

“In plain language, if the administration hasn’t delivered a financing plan by that time, the clock has run out,” said Mike Fisher, D-Lincoln, chair of the House Health Care Committee.

Shumlin has said he doesn’t want to release a plan that isn’t ready, but administration officials have said they will be prepared to deliver by the first of the year.

That doesn’t appear good enough for Republicans who plan to introduce amendments when the bill comes back to the House floor for final approval, which would require the administration to deliver the financing plan sooner.

“There’s nothing in this bill that gets us where we want to go,” said Rep. Doug Gage, R-Rutland, a member of the health care committee, during a brief party caucus prior to debate on the bill.

Gage encouraged fellow Republicans to vote against the legislation and continue to distance themselves from the state’s health care reform efforts.

The House version differs greatly and expands upon the Senate’s version, and if it gets final approval, a conference committee will need to reconcile those differences before the legislative session ends, which is expected to be next week.

The bill reaffirms and clarifies aspects of Act 48, the law that puts Vermont on a path to a publicly financed health care program by laying out a set of principles to guide the Legislature in decisions on how the program should be paid for and what services it should cover.

While the bulk of the legislation follows the overarching theme of preparing lawmakers to define the contours of Green Mountain Care, some sections of the bill are designed to tweak current practices in health care.

It raises the employer assessment and updates how the penalty, which is meted out to employers whose employees can’t afford the health plan they’re offered, will be indexed going forward.

There are provisions to ban certain practices by pharmacy benefit managers and increase their required reporting. It would also require regulatory oversight of urgent care centers.

A section of the bill that creates a pilot and study program for the use of adverse childhood experience questionnaires became a point of contention as Republicans questioned how the provisions would be implemented.

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Morgan True

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  • Dave Bellini

    The legislature already passed a law and the Governor totally ignored it.
    The Governor is going to do what he pleases, when he pleases. The legislature is just rubber stamping his orders and pretending to be relevant.

  • Bob Stannard

    With friends like her….

    • Keith Stern

      She’s not supposed to be a friend, she’s supposed to be a representative of the people and act on the people’s behalf. If we had more like her in office we wouldn’t see tax increases every year and companies bailing on Vermont.
      Tough to grasp but Shumlin should be willing to keep us in the loop about such a huge undertaking.

    • Estella Leach

      Thanks Keith, that is exactly right.

    • J. Scott Cameron

      Bob, you’re a good man, but you’ve got to turn the same critical eye to the actions of your ‘friends’ that you do to the actions of others. Hold Democrats and Republicans to the same standard. Otherwise your own credibility goes right down the toilet. “My Party right or wrong” doesn’t fly. How about looking out for the greater good?

      Browning is a hero and she is proceeding at great personal risk to her political future. She has already been ostracized and villified by her colleagues in the House for standing up for what is right. The Dems will probably recruit someone to run against her. Independent thinking is not a value in the Vermont Democratic Party anymore. If you are not a true believer step to the rear.

      Shumlin does not deserve anyone’s support on his efforts to hide this particular baloney until after the election. This is the most important state initiative in decades and the incompetency and lack of transparency is shameful. If a Republican governor was doing this you would be all over her.

      • Mark Milazzo

        Well said Mr Cameron.

  • Jamie Carter

    Shumlin has gotta go, his disdain for being held accountable and having to follow the laws like the common man are showing. Tough Pete, you signed Act48 into law, now pay the piper. Incomplete or not, the people need to know what the thought process is so they can weigh in… that’s the democratic process.

    If Pete can handle his roles at the DGA and the State perhaps he should resign as governor.

  • Craig Powers

    If the financing could be done without wrecking the VT economy, making VT businesses uncompetitive versus our neighboring states and taxing it’s citizens at ridiculously high rates (just to name a few things)….it would have been brought forth when mandated by law in 2011. Here we are three years later and our leadership has shown us nothing. They have broken the law, undermined the confidence of their citizens and businesses and continue to create huge uncertainty.

    I say, shame on them, for putting the cart before the horse and providing “pie in the sky” talking points to buy votes.

    When the people most impacted actually wake up and finally see what has been going on since 2011, there will be a huge political price to pay. Watch what happens during the mid-term elections in Washington this Fall.

  • Kelly Cummings

    I can remember the days when all of the opponents of
    universal healthcare
    wanted Governor Shumlin to slow down. Now
    all they are saying is speed up! Whatever fits their
    strategy and agenda at the time.

    They railed against VHC because it didn’t go as smoothly
    as we all would have liked. Of course, it was a huge
    undertaking and to not expect problems was just silly. But
    if you were looking for a moment to exploit, this was
    as good for them as any. So now that the Governor
    would like to take a little more time to get things right….
    well, that’s not good enough either.

    Opponents say he’s playing politics! Ha! That’s pretty
    funny. Take a look in the mirror because opponents are sure enough playing politics too!

    And actions like Ms. Brownings are not helping with the
    political climate. It’s becoming a lot like the Jerry Springer
    Show. After repeatedly seeing her cheered on by opponents of
    universal healthcare I can’t help but wonder about her
    motivations. A nice shiny moment in the spotlight. But be careful,
    Ms. Browning, because just might be, when they’re done with you, they’ll pull the plug on you. And you’ll find yourself
    standing middle stage….in the dark.

    It’s too bad really. The opponents have turned this in to the Browning and Bailey
    Circus. Kinda sad. I think Ms. Browning, you might be
    being manipulated by the opponents. I don’t think they so much
    care about you….as much as they care about their agenda.

    Prepare yourself. Because frankly, it would just be silly not to.

    • Jerry Kilcourse

      Well said Kelly and with wonderful style…those attacking Act 48 are just the newest members of a long lists who have historically fought against real health reform, usually motivated by self-interest. This is one reason why any reforms at all have come incrementally at a glacial place. We could of had real reform decades ago with better results at lower costs.

    • Chris Lewis

      In other words, ‘sit down and shut up Ms Browning. Only the activist and liberals have a right to speak their mind in this state.’

      • Jerry Kilcourse

        Only stating the obvious, Act 48 or no Act 48.

      • Kelly Cummings

        Nope. That’s not what I said at all.

  • Pat Robins

    With 95% of vermonters covered at present and more to come in the next ACA enrollment, it is inconceivable to most of us in the business community why Vermont would take the risk of dismantling the present coverage model with no way to make a U-turn if single payer gets out of control. Add to that a $2BB+ tax package which likely will include a payroll tax and income tax increases, which will almost certainly clobber the profitability of most companies,and you wonder why business folks are frightened??

    • Jerry Kilcourse

      We could have 100% covered but it still not have comprehensive health care for all. As others have pointed out, high out of pocket costs, prevent many for accessing health care, assuming they can afford the premiums. This has been the problem along with many, if not most, health insurance plans. $6000+ is not an insignificant amount for those who are barely able to pay the premiums on the Bronze plans, for example.

    • Lee Russ

      Come on Pat, you’re informed enough to know that the “2BB+” replaces the even larger amount already being paid already being paid for medical insurance premiums. And I assume informed enough to know that being “covered” is a far different thing than being able to get the healthcare you need. Not to mention that we have every reason to expect that this amount of taxes will buy considerably more health care than the same amount of premiums paid to commercial insurance companies.

      I doubt that all that many Vermonters are as content with the current system as you seem to be.

      • David Dempsey

        Lee, how much is the larger amount a being paid already for premiums? That has been mentioned many times, but I haven’t seen what that amount is. I’m not syaing you are right or wrong, but if you do know the amount I’d like to hear what it is..

  • sandra bettis

    omg – how hard is this? single payer is paid for by our taxes – we will all (100% of us) be covered and we will all be paying what we can afford – how hard is that to understand???

    • Keith Stern

      Taxes are not all set according to what we can afford. Mrs. Peter Welch should know that as well as anyone but she is now another rich liberal that doesn’t have to struggle to make ends meet anymore.
      Property taxes can be a very regressive tax along with sales and fuel taxes.

  • Kathy Callaghan

    “omg – how hard is this? single payer is paid for by our taxes – we will all (100% of us) be covered and we will all be paying what we can afford – how hard is that to understand???”

    If it were only that simple, it would have been done long ago. Unfortunately, the rhetoric doesn’t match the reality. Pat Robins has it exactly right.

    • Jerry Kilcourse

      “If it were only that simple, it would have been done long ago. ”
      It would be that simple if it wasn’t for the lobbying power of the medical/insurance industry complex! It’s the reason why the “public option” never got off the ground when the ACA was taking shape. There are many who have huge financial interests in the current system who will fight any attempt to have a more efficient, less expensive universal plan.

      • Lee Russ

        Don’t leave out the local insurance agents and agencies around Vermont when talking about financial interests opposing Green Mountain Care.

        • Craig Powers

          There goes Mr. Russ again. Throwing poison darts on chat boards at those who would challenge his Vermont Worker Center talking points.

          Most agents and agencies in VT gave up providing health as a product due to Act 48 and what it did to demonize them. Now what the population is left with is a broken website, mass confusion, higher premiums, higher co-pays…and the list goes on. We also have an administration that has broken the law and not provided financing details for three years.

          You should be very proud of your reforms Mr. Russ. Keep up the good work!

  • Kathy Callaghan

    “It would be that simple if it wasn’t for the lobbying power of the medical/insurance industry complex!”

    WHAT lobbying power of the medical/insurance industry complex?

    The only “medical/insurance” industry in Vermont is Blue Cross, which is in lockstep with the Governor, and has always been a friend of the Administration.

    I repeat, if it were this easy it would have been done long ago. If it were this easy, the Governor would have been shouting it from the mountaintops.

    There is a reason Vermonters can’t get any details on the Administration’s work to date, and that is not because the news is good. This is too big an issue for blind faith.

    • Jerry Kilcourse

      “What lobbying power of the medical insurance complex?” The power industry lobbyists are pretty well known to most. Some better know examples are:
      The $14 to $16 million TV ” Harry and Louise Ads” using scare tactics from the Health Insurance Association of America that helped torpedo the Clinton health plan in 1994…including such false statements such as ” I don’t want the government telling me what doctor to see!” -Louise-
      According to Bernie Sanders, the insurance lobby spent over a $million per day against the public option a few years ago.
      Another was the AMA that has always been against “single payer” and coined the term “socialized medicine” to associate it with communism during the the cold war in the 50’s and early 60’s. That label as stuck around and is still being used by some ideologues.
      Most of the lobbying however is done behind closed doors in private conversation with law makers that you and I never get to hear about.

      • Keith Stern

        The Democrats passed Obamacare against public opinion and against better judgment from economists and others who could see what a disaster it would be and now we are seeing that disaster unfolding. So you want the same clowns to do even more damage? Really?

  • Keith Stern

    Mark Donka has a plan that would really make health insurance affordable while simplifying the process, not burdening the taxpayers, and not increasing the size and scope of government. Tear that concept down.

    • Jason Farrell

      I’ve seen you make this claim now on a couple of posts, so again, I ask – could you please provide me with a link to Mr. Donka’s “plan that would really make health insurance affordable while simplifying the process, not burdening the taxpayers, and not increasing the size and scope of government.”

      Nothing I read on could be construed as a “plan”.

  • Ralph Colin

    There’s another point here which seems to be overlooked by almost everyone except Cynthia Browning.

    The Governor is telling us that he is above the law. He is the only one among us who may do as he pleases. Laws are not binding upon him. He needn’t abide by the provisions of the laws he himself signed!

    Cynthia is apparently the only person in the legislature who is willing to take him to court. She may not be your idea of a friend, Mr. Stannard, but I think she’s a hero, a real stand-up person.

    What kind of an example is the Governor giving to the young people in our state? Do as I do and just ignore our laws? That’s a real winner, isn’t it?

    And you may recall that just a few months ago he tried to screw his neighbor until a few folks reminded him that what he was trying to do was illegal.

    Does anyone consider the fact that he might just be a hypocrite? Or a law-offender? Is that the type of person who we want for our Governor? Maybe Bob Stannard feels comfortable with that, but I doubt that most other Vermonters who understand what’s going on here and are shocked by it would agree with Stannard.

  • David Dempsey

    There are many reasons why it is important to get some idea of how this is going to work. In my case, I am on disability for a mental illness and my employers policy is to cover disabled people until they turn 65 under their Erisa plan. Gov. Shumlin has said that he wants to make companies who have Erisa plans also pay the payroll tax, if that becomes the source of funding for GMC. I don’t think my employer would be to crazy about paying both the tax and the cost of their Erisa plan. If they drop the Erisa plan, I would get my coverage from GMC. If that happens, I would like to know how much I would have to pay out of pocket for my appointments and meds, which are very expensive but necessary. I would like to know if I will be able to afford them and continue my treatment. My disability insurance payments are only about a third of what my salary was when I was working That’s all I want to know, no politics from me.