Editor’s note: This article is by Rick Jurgens of the Valley News, in which it was first published Nov. 6, 2014.
Vermont Gov. Peter Shumlin’s narrower-than-expected margin of victory — 2,088 votes with 100 percent of precincts tallied — over Republican challenger Scott Milne cast a political shadow over Shumlin’s plans to reform health care and implement a system of publicly financed universal insurance coverage.
But despite the mixed message in Tuesday’s election, backers of so-called single-payer health insurance vowed to push ahead. Up next is the consideration of a detailed, $2 billion health care financing proposal that Shumlin has promised to unveil in January.
“I’m not going to say single-payer’s dead because we don’t know what we’re talking about until we see it,” said Sen. John Campbell, a Quechee Democrat and president pro tempore in the Senate. “I believe we have an obligation to review the plan that the governor is going to bring before us in January.”
That duty — to Vermonters, not just to single-payer supporters — requires consideration of the plan’s financial viability and its impact on efforts to curb health care costs, he said.
And if the plan fails the viability test? “We plug on and find another solution,” Campbell said, noting that a new approach could emerge from the Senate, where members of the finance and health and welfare committees have been “looking at the problem and … ways to attack it.”
Sen. Anthony Pollina, a Progressive Party member who caucuses with the Democrats, saw in the election results “a setback, without a doubt,” but counseled patience. “What’s important (is) that we do it right, not that we do it quickly,” he said. “Going slow might be the appropriate thing to do.”
Health care reform is difficult, he added: “You have to expect it to take a while to take shape and be implemented.”
Single-payer supporters should be willing to “start the conversation over at a different place,” perhaps taking the insurance plan that currently covers state employees as a starting point, Pollina said. A proposal from the state Senate might fit into a renewed conversation, he said.
But Sen. Joseph Benning, a Lyndonville Republican who is the body’s minority leader, had a different prognosis for single-payer. Noting Vermont’s aging population and shrinking work force, he suggested that health care reform was a topic suitable for “a national level discussion, not a state of Vermont” discussion.
Single-payer advocates don’t see it that way.
Rep. Sarah Copeland-Hanzas, a Bradford Democrat, said the opinion that Vermont should abandon its role as single-payer path-breaker was “an easy conclusion to come to,” but one that underestimated Vermonters’ willingness to address the “fundamental unfairness in our system” of health care.
Rep. Donna Sweaney, a Windsor Democrat, said she doubted that the federal government would ever take the lead in moving toward a single-payer system, which would affect the big businesses that sell health care and insurance — “there’s too much at stake.” And it is too soon for Vermont to give up: “If it can be done anywhere, it can be done here,” she said.
That was a point that Milne challenged during his campaign. What Shumlin described as an attempt “to do in Vermont what has taken too long” elsewhere in the country, Milne attacked as “Peter Shumlin’s radical experiment with health care.” In an interview Wednesday, Milne said he estimated that about 35 to 40 percent of the voters liked single-payer, while about the same number “think it’s the devil.”
Milne saw in the election results a rejection of his opponent’s stewardship of single-payer. “Even those that really liked the idea really questioned whether Peter Shumlin is the guy who can get it done at this point,” he said.
Some bipartisanship seems to have survived the election, however. For example, even as he attacked single-payer during his campaign, Milne expressed his support for some provisions of the state’s 2011 health reform law, including the establishment of the Green Mountain Care Board to rein in insurance costs and hospital and medical spending.
Similarly, Benning affirmed his support for the cost-cutting efforts of the Green Mountain Care Board and his preference “to have the Vermont Health Connect work.”
Ongoing problems and the pre-election shutdown of Vermont Health Connect, the health insurance website set up as the state’s federal Affordable Care Act-mandated shopping site for health insurance consumers, became a high-profile embarrassment for the administration. Shumlin acknowledged that website problems had “undermined the confidence of Vermonters in believing that government can get health care right.”
Legislators confirmed that observation. Sweaney recalled hearing this from voters: “If you can’t get the website right, how are you going to get the rest of it?”
Copeland-Hanzas vowed to “hold the administration’s feet to the fire” to ensure that Vermonters could enroll in health insurance plans for 2015 and collect the premium subsidies to which they were entitled under the ACA.
In the wake of the website fiasco, Shumlin saw his share of Tuesday’s votes slip to 46.4 percent, down sharply from his 57.8 percent majority in 2012 (although not much lower than his 49.5 percent plurality in the 2010 race that first landed him in the governorship).
The Democratic majority in the Legislature also sagged, with Republicans — who now hold 45 of the 150 seats in the House of Representatives and seven in the Senate — gaining at least nine House seats and two Senate seats, according to a VtDigger tally. Among the losers was Michael Fisher, the Lincoln, Vt., Democrat who chairs the House Health Care Committee.
Sweaney said that the addition of Republicans to the Legislature might lay the groundwork for a more bipartisan effort on reform. “Having folks with different ideas and thoughts and concerns will be helpful,” she said.
Legislators on both sides of the aisle stopped short of interpreting the election as a verdict on health care reform. “Everyone thinks that this is a referendum on single-payer,” Campbell said. “There were so many different issues that people were concerned about.”
Sweaney said concerns about property tax reforms and education issues ate into Shumlin’s margin, along with doubts about single-payer and how it would be financed. Some voters were impatient with the administration’s failure to meet deadlines to put plan details out on the table, she said.
“Just saying ‘I’ll get it to you in January’ is wearing thin with people,” Sweaney said.
And Benning agreed — sort of — that Shumlin’s mandate for single-payer hadn’t been a direct subject of the election. “I think since we’ve never really had anything other than an abstract concept, it’s hard to figure out what has changed,” he said.
Pollina said that “the real political danger” of the election is that it might prompt Republicans and lukewarm supporters of single-payer reform to back away from the project.
Bea Grause, president of the Vermont Association of Hospitals and Health Systems, said that while she didn’t know how the election might have changed the politics of health care reform, “on the policy side, it doesn’t change what we’re doing.”
Grause pledged to keep working for health care reform, including changes in how providers are paid, with its goals of improving affordability, lowering costs, expanding coverage and making health care better for patients and providers.
Single-payer is “a potential strategy to achieve these goals,” she added. “We’re keeping our eyes on that prize.”
Rick Jurgens can be reached at rjurgens@vnews.com or 603-727-3229. Valley News staff writer John P. Gregg contributed to this report.
