The House of Representatives passed a health care reform bill Thursday by an 89-44 margin after a heated debate over when the governor should produce a financing proposal for the state’s planned universal health care program.
It’s a debate that has played out several times on the House floor, with Republicans seeking to introduce amendments that would compel the administration to show its work. Those efforts failed again Thursday.
“I find it disturbing that this Legislature refuses to hold the administration accountable,” said Rep. Kurt Wright, R-Burlington, who like many Republicans is incredulous that there has been no repercussion to Gov. Peter Shumlin’s repeated delays in presenting a financing plan.
Republicans argue that Shumlin is playing politics with the financing plan by delaying until after the upcoming election.
“I can’t believe this body is going to stand back and say ‘let’s just give them a pass on this,’” Wright added, echoing a sentiment expressed in floor speeches of several members of his party.
Act 48, the 2011 law that puts Vermont on the path to universal publicly financed health care, included a requirement that the administration present its financing plan in January 2013. However, the law did not spell out any consequence if that deadline was missed. Last year the Shumlin administration declined to provide details and promised to reveal the plan in 2014, but last month officials said they would not present financing options for the governor’s single-payer plan until next year.
Though the deadline is long passed, said Rep. Mike Fisher, D-Lincoln, chair of the House Health Care Committee, lawmakers settled on the wrong date. That’s because when Act 48 was passed, many people believed Vermont would get a waiver from the Affordable Care Act closer to the original deadline, Fisher said.
Democrats have argued that it doesn’t make sense to force the administration to present an incomplete plan, or set new unrealistic deadlines.
The underlying bill requires the administration to present its proposal to lawmakers by Jan. 15, 2015. If the plan is not ready by that time, the statute mandates a funding freeze for Green Mountain Care.
Rep. Topper McFaun, R-Barre Town, said if Democrats are opposed to deadlines, then including one that cuts off funding, effectively hobbling the reform effort, seems paradoxical.
The bulk of the legislation passed Thursday focuses on clarifying and reaffirming aspects of Act 48 and ensuring lawmakers will have access to the information they need during the next legislative session to pass laws that will set the program in motion.
However, other sections of the bill raise the employer assessment and increase regulation of pharmacy benefit managers and urgent care centers.
Fisher succeeded in including an amendment that would require urgent care centers to take patients regardless of whether they have health insurance.
The amendment is in response to concerns raised by advocates and hospitals that the company ClearChoiceMD, which plans to open five urgent care centers in Vermont, won’t provide care to patients who can’t pay.
Others have welcomed the company, which will offer a lower price alternative to care in an emergency room for people with non-life threatening injuries and illnesses who can’t get an appointment with their primary care doctor.
Executives for ClearChoice were not immediately available to comment on how the proposed law change would impact their business model.
The bill differs greatly from the Senate-passed version, and a conference committee of the two chambers will now have to hammer out a compromise.
