Feliciano claims Shumlin wants to ‘take over’ Medicare

Libertarian gubernatorial candidate Dan Feliciano says Gov. Peter Shumlin is planning to “take control” of Medicare benefits as part of a single-payer health care program. A Shumlin campaign official called the claim untrue and a “scare tactic.”

Feliciano said he is “ringing the alarm bell” on Shumlin’s plan to use a federal Medicare waiver to “offset the costs of the single-payer program,” he said at a news conference Tuesday in Montpelier.

Libertarian candidate for governor Dan Feliciano holds a news conference on Medicare. Photo by Morgan True/VTDigger

Libertarian candidate for governor Dan Feliciano holds a news conference on Medicare. Photo by Morgan True/VTDigger

The Shumlin administration is seeking an all-payer waiver to allow Vermont to set Medicare reimbursements — or what and how the program pays doctors and hospitals. Administration officials say the waiver would not allow them to change Medicare’s benefits.

“Medicare benefits are protected by federal law, and it’s never been our intention to take away or reduce people’s Medicare benefits,” said Robin Lunge, director of Health Care Reform for the Shumlin administration.

Legislation passed this year clarifies Green Mountain Care’s relationship to Medicare, making it the secondary payer for Medicare beneficiaries in Vermont. That means services or costs that Medicare doesn’t cover, which Green Mountain Care may, would then be paid for by Green Mountain Care.

However, Feliciano contends Vermont will use a potential all-payer waiver to put federal Medicare dollars in the General Fund and use them to pay for a universal, publicly financed health care program — often called single-payer.

That contention is based on his understanding of how Maryland’s all-payer waiver works, Feliciano said.

But nothing in the Centers for Medicare and Medicaid Services description of its agreement with Maryland indicates that the program’s benefits can be altered, or that Medicare money can be used to pay for services to non-Medicare beneficiaries.

Maryland is the only state with an all-payer waiver, which it has had since 1977. The waiver allows Maryland to set the rates for Medicare payments to hospitals. It’s part of an all-payer system that requires that “all third-parties pay the same rate” for hospital services, according to CMS.

Under a modified waiver agreement this year, Maryland will use the waiver to make capped, or global, payments to hospitals. The payments are adjusted based on the population a hospital serves and patient outcomes.

If the agreement doesn’t save Medicare money and improve care for its beneficiaries in its first five years, the modified waiver won’t be renewed, according to CMS.

Vermont is aggressively pursuing similar value-based capped payment models, and the all-payer waiver it is seeking would allow the state to set reimbursements for all health care providers — unlike Maryland, which just sets reimbursements for hospitals.

“If Medicare in Vermont continues to pay providers through a fee-for-service model, that undermines the providers’ ability to move to new payment models,” Lunge said.

Fee-for-service is a term for the current payment model in which doctors and hospitals are paid for each component of a service.

The news conference at the Statehouse drew three reporters, Felciano, his wife, Carol, and Darcie Johnston, his de facto campaign manager, as well as a couple from Grand Isle who are covered by Medicare.

Kay Trudell, 67, said Johnston invited her and her husband to the event, which she attended because she’s against the Shumlin led “socialist takeover of medicine.”

Trudell said she’s concerned that Shumlin and his administration aren’t being honest with Vermonters about how a single-payer program would impact Medicare.

“I don’t want (Shumlin) experimenting with our Medicare dollars,” Trudell said.

Peter Sterling, director of the single-payer advocacy group Vermont Leads, said Feliciano is using scare tactics to rile Vermont seniors a month before the November election.

“There’s no evidence that the administration would be able to do this even if they wanted to,” Sterling said, adding that he hasn’t seen any indication that the administration or other elected officials want to change Medicare benefits.

Scott Coriell, Shumlin’s campaign manager, issued the following statement in response:

“Vermonters deserve better than a scare tactic from their gubernatorial candidates. Green Mountain Care would do nothing to change Medicare. Seniors will still access care through Medicare as they do today. In fact, seniors will have the added protection of Green Mountain Care which will serve as supplemental coverage beyond the benefits of Medicare. I am glad that Dan sees the benefits of Medicare, a government-run health care program that provides universal access to seniors and asks them to pay based upon their ability. We think such a system makes sense for all Vermonters, not just seniors.”

Morgan True

Leave a Reply

47 Comments on "Feliciano claims Shumlin wants to ‘take over’ Medicare"

1000

Comment Policy

VTDigger.org requires that all commenters identify themselves by their authentic first and last names. Initials, pseudonyms or screen names are not permissible.

No personal harassment, abuse, or hate speech is permitted. Be succinct and to the point. If your comment is over 500 words, consider sending a commentary instead.

We personally review and moderate every comment that is posted here. This takes a lot of time; please consider donating to keep the conversation productive and informative.

The purpose of this policy is to encourage a civil discourse among readers who are willing to stand behind their identities and their comments. VTDigger has created a safe zone for readers who wish to engage in a thoughtful discussion on a range of subjects. We hope you join the conversation.

Privacy policy
Sort by:   newest | oldest | most voted
Thomas Powell
2 years 2 months ago
“Medicare benefits are protected by federal law, and it’s never been our intention to take away or reduce people’s Medicare benefits,” said Robin Lunge, director of Health Care Reform for the Shumlin administration. Language matters. “It has never been our intention” is a classic disingenuous hedge. How about “We won’t” as an alternative? The credibility of this administration is hideous when it comes to doing what they say they will do in health care. Ms. Lunge’s assertion is about as unconvincing as it is unsupported by Shumlin’s record. When the Legislature starts eroding funding for the Single Payer Plague, watch… Read more »
Walter Carpenter
2 years 2 months ago

“Medicare benefits are protected by federal law, ”

This is the key phrase here. Even if the Shumlin Administration wanted to, which they do not, how could they do it if the benefits are federal law?

2 years 2 months ago
Here is what the language in Act 48 actually says regarding Medicare, with emphasis added: “The director, in collaboration with the agency of human services, SHALL obtain waivers, exemptions, agreements, legislation, or a combination thereof to ensure that, to the extent possible under federal law, ALL FEDERAL PAYMENTS PROVIDED WITHIN THE STATE FOR HEALTH SERVICES ARE PAID DIRECTLY TO GREEN MOUNTAIN CARE. GREEN MOUNTAIN CARE SHALL ASSUME RESPONSIBILITY FOR THE BENEFITS AND SERVICES PREVIOUSLY PAID FOR BY the federal programs, including Medicaid, MEDICARE, and, after implementation, the Vermont health benefit exchange.” (Page 12) And, “The agency SHALL SEEK PERMISSION from… Read more »
Morgan True
2 years 2 months ago
Hi Robert, I believe you are working from Act 48 as passed. Current statute for Green Mountain Care and Medicare is as follows: http://www.leg.state.vt.us/statutes/fullsection.cfm?Title=33&Chapter=018&Section=01827 (e) The Agency shall seek permission from the Centers for Medicare and Medicaid Services to be the administrator for the Medicare program in Vermont. If the Agency is unsuccessful in obtaining such permission, Green Mountain Care shall be the secondary payer with respect to any health service that may be covered in whole or in part by Title XVIII of the Social Security Act (Medicare). According to Robin Lunge, Vermont has already sought and been denied… Read more »
2 years 2 months ago

Thanks, Morgan.

2 years 2 months ago

But as I read this, it doesn’t preclude the state from seeking those wavers again in the future, and the intent of the original legislation to seek a waver remains intact. They’ve just put a plan B into place until such a time as the waver can (if ever) be obtained.

2 years 2 months ago

And, Morgan, thanks again for confirming that Robin Lunge’s statement regarding Vermont having been denied a Medicare waiver was untrue.

Karen McCauliffe
2 years 2 months ago

Morgan, Would you please supply a link to the data that “Vermont has already sought and been denied permission to administer Medicare as part of Green Mountain Care. “? I have been unable to find the link in my data search. Thanks for your assistance.

Also Rob Roper brought up an important point that the waiver should be able to be applied for repeatedly.

Jamie Carter
2 years 2 months ago

While I agree the statement

“It has never been our intention” is a bit scary, especially from the Shumlin Admin, language does matter, specifically this part…

“Medicare benefits are protected by federal law”

Feliciano is panicing with this statement as the latest poll shows him with like 7% of the probably vote and trying to drum up the support of the elderly. Very sad from a guy that otherwise has some very good ideas and is pretty level headed.

Kay Trudell
2 years 2 months ago

Thomas Powell, you have made several excellent points. I agree.

Linda Lee
2 years 2 months ago

Agree. Hang on, seniors.

2 years 2 months ago

Medicare plans would be a good question for tomorrow night’s debate.

Gov. Shumlin should be asked what his intentions are regarding Medicare. The questioners should demand a straight forward and unambiguous response from the Governor.

Jamie Carter
2 years 2 months ago

Why? It’s pretty clear already …

“Medicare benefits are protected by federal law”

Shumlin’s intentions are 100% irrelevant.

Lets keep are eye on the ball here and ask him real questions. It was silly when they asked Dubie if he would ban abortions 4 years ago and it’s equally as silly to ask Shumlin what he is going to do with Medicare funds.

2 years 2 months ago
Jamie, thank you….but I don’t need your advise on what is or is not a silly question. If the people and legislature had been asking the Governor “real questions” and getting honest answers, we wouldn’t be in the mess we have today. The Governor has failed to deliver on everything he has promised to date on health care reform. Furthermore, he has been less than honest and straight forward with the people as the reform process has has embarrassingly stumbled around. Why should we let him any where near Medicare based on his record with health care? So lets hear… Read more »
Jamie Carter
2 years 2 months ago
Whether the feds give the state the money from medicare to pay the bills or pay the bills themselves… does it really matter. The benefits and the amount of those benefits are still determined by the feds. As long as you can go to the doctors and have it covered exactly as it is now does it matter if the payment comes from Vermont or United States of America? “Why should we let him any where near Medicare based on his record with health care?” We shouldn’t and he can’t touch medicare. Sure IF there is a waiver the state… Read more »
Patricia Crocker
2 years 2 months ago

And it won’t just be Medicare…according to Shumlin, “Everybody In” Right from the horse’s mouth…https://www.youtube.com/watch?v=SC92CPki-j0

Wendy wilton
2 years 2 months ago
Because Medicare reimburses at a higher rate than Medicaid it will be used in the single payer plan to offset the burden of Medicaid. The cost shift continues, but this time Medicare will be a beast of burden, whereas it is only private insurance that plays that role today. In order to save money to meet the budgetary cram downs by the stateone access in the new single payer system will be diminished. Sure the benefits may be the same, but what does it matter if you can’t be treated in a timely manner due to a lack of resources… Read more »
Ron Pulcer
2 years 2 months ago

Wendy, with all due respect, regarding VA healthcare, it is clear that Congress started a second war without putting it on the budget, and also did not “plan” for increased healthcare needs for returning Veterans.

“Lack of resources”, as in Congress did not plan or allow for VA to hire more physicians and nurses. Both political parties in Congress are to blame for that.

Walter Carpenter
2 years 2 months ago

“as in Congress did not plan or allow for VA to hire more physicians and nurses.”

Not to mention that they have also blocked funding for the VA, especially at a time when so many, many veterans from our last decade of wars are coming into it.

Glenn Thompson
2 years 2 months ago
From the article! “Peter Sterling, director of the single-payer advocacy group Vermont Leads, said Feliciano is using scare tactics to rile Vermont seniors a month before the November election.” Scare tactics???? That is hardly the word I would use to describe Feliciano’s concerns! Reading this article does lead to a question? When I signed up for Medicare and a Medicare Supplemental plan….I had several choices to choose from for Supplemental plans. The question becomes…..if a single payer system is implemented will those on Medicare (Vt. residents) be *forced* into the one and only Green Mountain Care system Medicare Supplemental Plan?… Read more »
2 years 2 months ago

Great point, Glenn. Discussion about the role and cost of supplemental insurance under Green Mountain Care has been sorely neglected by the politicians (because it’s likely and uncomfortable conversation) and the media (because…. who knows why?).

Jamie Carter
2 years 2 months ago
Glenn, it’s pretty clear that GMC will be secondary to tricare and medicare. If you want to classify it as something other then single payer then that’s fine. No one has ever officially called it single payer, that’s only be the term bandied around the internet. Feliciano is off base with this comment. There are many reasons to be skeptical of the plan for “single payer” or “universal health care” or what ever you want to call it, but this really isn’t one of them. This is a straight out of the Sanders playbook to freak out the elderly and… Read more »
2 years 2 months ago

“No one has ever officially called it single payer, that’s only be the term bandied around the internet.”

Are you freakin’ kidding me? Here’s what the governor Shumlin said when launching Green Mountain Care:

“We are the first state that is affirming that we are going to implement a single-payer health-care system,” Shumlin http://www.bloomberg.com/news/2011-05-26/vermont-s-shumlin-uses-obama-health-law-to-build-bridge-to-state-run-care.html

“Single payer” is how this scheme was sold to Vermonters by activists and politicians in Vermont. To say it wasn’t is really dishonest.

Jamie Carter
2 years 2 months ago
“Are you freakin’ kidding me? Here’s what the governor Shumlin said when launching Green Mountain Care: ” Where did you get that…. the internet? Doh!!! Mr. Roper, with all of your political knowledge and following of the issue, the fact that somewhere at some point in all this it was called single payer fooled you into believing that it was in fact, a to the letter, textbook definition, of a single payer system is a little dishonest, or really sad… actually its really kind of both. Have people used the term, sure. But let’s be real here, it isn’t a… Read more »
Ethan Rogers
2 years 2 months ago

The wording was changed from ‘secondary’ to ‘payer of last resort’, which still makes no sense as Tricare is, by federal law, the ‘payer of last resort’.

Glenn Thompson
2 years 2 months ago
Jamie Carter, “Glenn, it’s pretty clear that GMC will be secondary to tricare and medicare. If you want to classify it as something other then single payer then that’s fine.” Jamie, the ‘Red Flag’ went up in my mind wondering how Single Payer would effect Medicare Supplemental plan choices offered to seniors who are on Medicare? Currently there are several options to choose from! Everyone should be aware under Federal Law, all Medicare Supplemental plans *MUST BE IDENTICAL*. Prices vary with provider. FYI, when I signed up, I really wanted to go with AARP because their rates are substantially lower… Read more »
Walter Carpenter
2 years 2 months ago

“Scare tactics???? That is hardly the word I would use to describe Feliciano’s concerns!”

I agree with Peter here. I am sure that Mr. Feliciano is concerned, but he is also using scare tactics.

Glenn Thompson
2 years 2 months ago

Walter, perhaps you would like to take a crack at it? Do all Medicare Supplemental plans currently offered in Vermont go away under the Single Payer System?

Pay special attention to page 20 of this link!

http://www.fjgfinancial.com/images/userfiles/files/resources/Shopping_MedSupp_1-09.pdf

Dan Carver
2 years 2 months ago

Shumlin’s team calls Feliciano’s message a scare tactic. Yet, if Shumlin had delivered on his promise of details 20+ months ago, then Feliciano would not be able to fill Shumlin’s void with potential threats.
This job is just too ig for Pete. He’ll most likely win, yet Vermonters will lose.

Walter Carpenter
2 years 2 months ago

“yet Vermonters will lose”

They might win, too.

Bob Zeliff
2 years 2 months ago

I see Feliciano’s statement as intentional misinformation. He is projecting that Vermont will violate federal law! The Governor, the Legislature, etc, etc. Does anyone really have such a low opinion of Vermont to believe that?

Feliciano disgraces himself.

I also see several commenters here jumping on his disgraceful band wagon.
Are they so partisan that they no longer remember what Vermont is? Shame on them.

2 years 2 months ago

Bob, nobody is saying Vermont will disregard federal law. Vermont is seeking a WAVER from federal law. The whole reason the start date for Green Mountain Care was set for 2017 is because that’s when federal law says the state can apply for those wavers. Our federal delegation of Sanders, Leahy, and Welch has pledged to work toward getting those wavers. And Act 48, as quoted in my comment at the top of this thread, compels the state government to do all in its power to obtain them. That’s not violating the law, that IS the law.

Keith Stern
2 years 2 months ago

Don’t forget that we have a president who will skirt the laws and use executive orders to get what he wants. Don’t doubt for a minute that he will allow a fellow liberal to get around the law to accomplish their misguided goal of single payer.

bob belisle
2 years 2 months ago
I am on Medicare with a supplemental of my choice. I am totally covered with both policies. I do pay extra premiums but I do get 100 percent coverage. Many people I discuss about single payer have the same concerns. I recieve reimbursements from my prior employer for the extra cost. Also, what about Vermont employers that self insure and have workers spread across the country working out of state. Many issues have to be answered. I wonder if the State is savy enough to solve all these issues. Lets not forget the affordable care Act implementation problems.
John McClaughry
2 years 2 months ago
It’s true that federal law guarantees Medicare benefits. Let’s take a hip replacement as a Medicare benefit. And let’s suppose GMC becomes responsible, via a waiver, for paying for the guaranteed “Medicare benefits”. Note: these are not like “food stamp benefits”, where if found eligible you get a debit card amount to purchase what food you choose off the shelf at the supermarket. A hip replacement requires a doctor and hospital, both controlled by and paid by GMC, to prescribe the operation. Too many hip replacements may threaten the hospital’s “global budget”. The GMC Board, strapped for funding, may decide… Read more »
2 years 2 months ago

The Johnston-Feliciano scare tatics are obvious as they are desperate to gain some traction in the polls. What’s next. Death panels?
Meanwhile:
“Kay Trudell, 67, said Johnston invited her and her husband to the event, which she attended because she’s against the Shumlin led “socialist takeover of medicine.” Interesting statement that speaks for itself and is what opponents said about Medicare back in the early 60’s.

Keith Stern
2 years 2 months ago

So how is medicare working for us in reality? Healthcare providers are under compensated by medicare so there is increased pricing elsewhere to make up the revenue gap. So what would happen to health care bills if the providers were paid a reasonable amount by the federal government?

Kay Trudell
2 years 2 months ago
So, Jerry, you see nothing wrong with both Obama and Shumlin stealing money from Medicare to fund their socialist takeovers of ALL of medicine and healthcare in VT and the US? I daresay both you and I were too young in the 60’s to have had any knowledge or say in the establishment of Medicare, which has now been in place for over 50 years and has been deducting money from all of our paychecks for all that time. Medicare was supposed to be for SENIORS, not for everybody from cradle to grave. Let’s stick to what is actually being… Read more »
Kay Trudell
2 years 2 months ago
Another interesting question: many, many retired Vermonters travel and/or spend part of the year out-of-state in Florida, Arizona, North and South Carolina, etc. Has the Shumlin administration factored this into their plans? How will Medicare coverage in a single-payer state be handled for people who might need medical care and Medicare coverage while living for several months out of state? Will they have to return to Vermont for the services to be covered? Right now there is no problem. Medicare pays no matter which state you are in. I know this from first-hand experience. And what about travel? What about… Read more »
Darcie Johnston
2 years 2 months ago
Shumlin said at the Burlington Free Press debate today that he wants everyone one in. Vermonters on Medicare should be scared. The Green Mountain Care Board controls the rates doctors and hospitals will be paid and when you control the rates you control the service. This action alone changes the benefits. In addition, if you have to buy your Medicare supplemental through the Green Mountain Care Board you will not have any choice of supplemental plans or the price you will pay for this coverage. Why does Shumlin need to have Medicare people in his single payer system? Because he… Read more »
Jamie Carter
2 years 2 months ago
“Shumlin said at the Burlington Free Press debate today that he wants everyone one in. Vermonters on Medicare should be scared. ” Keep piling on the scare tactics BS…. This is precisely why the republicans in this state can’t gain any ground… Be scared people the boogey man is coming with his death squads to steal you money and children muahahahahahhaa I know it’s halloween but come on. Shumlin is not the boogeyman, he is a slick politician that has higher aspirations and needs to remain in the Gov’s seat for another 2 years to get there. Unfortunately for Vermont… Read more »
2 years 2 months ago

Those who are opposed to Act 48 will throw up any amount of flack in the hopes of creating fear and uncertainly for their own political and or ideological purposes.
While he (Feliciano) is trying scare to seniors and be a “savior” of Medicare, he would most likely have voted against Medicare at the time due to his “libertarian” ideology.

Joanne Esau
2 years 2 months ago
Scott Coriell, Shumlin’s campaign manager, issued the following statement: “……In fact, seniors will have the added protection of Green Mountain Care which will serve as supplemental coverage beyond the benefits of Medicare……” whew.. that is even more scary.. so Seniors will no longer be able to purchase the supplemental coverage of their choice because there will be NO CHOICES AVAILABLE in VERMONT. Everyone gets the “added protection of Green Mountain Care” regardless if you like the plan you have now with Blue Cross or MVP, you will no longer have that option. As I read this it also implies that… Read more »
Dave Bellini
2 years 2 months ago
The question that needs to be addressed is: What does a waiver mean for the Vermonters over 65 on Medicare? A new “single payer” could be,, a wrap-around for Medicare, if the new plan was significantly better than Medicare. Would Seniors be taxed? Probably yes. But, for the tax to be fair, the tax must be greatly reduced, as Medicare would be the primary payer. The best thing the state could do is to adapt the Vermont State Employees Health Plan as the model for all Vermonters. It’s way better than those crappy Obamacare plans. It will be more expensive… Read more »
Karen McCauliffe
2 years 2 months ago
Dave, Do not assume that using Vermont’s single payer as Medicare’s secondary coverage that will apply to coverage out of state other than limited coverage at Dartmouth. Look at Kay’s comment above left at 10:49 AM yesterday. Vermont’s single payer would need to purchase a separate supplemental policy for those Vermonters on Medicare or allow those seniors to still purchase a separate Medicare supplemental policy. Either way this is a cost that is not factored into Vermont’s single payer cost and a cost for these seniors. These seniors with Medicare would be taxed to pay for Vermont’s single payer and… Read more »
2 years 2 months ago
Starting with the Feliciano article above and all the comments that follow, it seems that no one really knows how seniors would be effected if Medicare were to be rolled into Gov. Shumlin’s single payer system. We do know that just about all the positive aspects of health care reform promised by Shumlin over the past four years have failed to materialize. Looking forward, there is nothing on the horizon presented by Shumlin indicating anything will change for the positive. So if you’re a senior, on Medicare, retired and likely on a limited income………is not knowing what may happen to… Read more »
Alan Sexton
2 years 2 months ago

This is more ugly news for the elderly – and disabled – in a state Kiplinger’s ranked second only to Rhode Island among the “10 Least Tax-Friendly States for Retirees,” and among the bottom 10 in USA Today’s “10 worst states for retirement.”

Love or hate Dan Feliciano, he’s dead right on this issue.

Hating on the messenger doesn’t change the reality that he’s right, it only indicates the blind partisanship of the attacker.

wpDiscuz
Thanks for reporting an error with the story, "Feliciano claims Shumlin wants to ‘take over’ Medicare"