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.
