BURLINGTON — Members of Vermont’s Health Care Is a Human Right campaign are calling on Gov. Peter Shumlin to “equitably” finance the state’s planned universal health care program.
Advocates say the Shumlin administration’s single payer program should be supported by a progressive tax structure that doesn’t shift costs from large businesses to smaller ones and individuals.
“Green Mountain Care should be funded by a mix of income taxes on earned and unearned income, wealth taxes and a graduated payroll tax for businesses with exemptions for the smallest of businesses,” said James Haslam, executive director of the Vermont Workers Center, at a news conference Monday.
The new program should not require cost-sharing for medical services. Haslam says copays, deductibles and coinsurance should be eliminated. There should be no out-of-pocket costs when people receive care, Haslam and others said.
Administration officials have hinted that their proposal for Green Mountain Care will include some elements of cost-sharing, which is likely to meet resistance from those who want health care services to be administered as a public good.
Shumlin has said he will release his financing plan before the end of the month, but Monday’s news conference was in response to aspects of that proposal reported by VTDigger.
VTDigger’s report cited sources with knowledge of previous versions of the proposal. The administration is still crafting the financing plan, according to one of its principal architects, Robin Lunge, director of health care reform.
“We are still modeling the impacts of financing options on Vermont individuals, families and businesses and changing things about the proposal to reflect policy changes made after seeing the impacts,” Lunge said in an email.
Shumlin said last week that the proposal will be released Dec. 29 or 30.
The administration has declined to comment on the details reported by VTDigger, but Secretary of Administration Jeb Spaulding affirmed in a recent radio interview that there will likely be an employer payroll and income tax or “public premium” as part of the plan.
The idea of a flat employer payroll tax — in the range of 6 to 9 percent — has raised concerns among advocates who argue that large companies, which typically pay a higher percentage of payroll toward employee health coverage, would pay less toward health care than they do now.
Small businesses, which pay a tax instead of offering coverage or offer coverage that eats up a lower percentage of payroll, would be disproportionately impacted by a flat tax.
Spaulding said the payroll tax would be phased in, reducing the immediate impact on small employers, but the administration has not said whether it will be a flat or graduated tax.
The lack of detail on the income tax side of the equation has created anxiety among advocates that it might not tax nonwage income, such as capital gains.
Haslam said he believes the details of Shumlin’s proposal will reveal it to be in line with what many advocates for universal health care in Vermont have waited to see for years.
Whatever the governor proposes will be a “starting point” for advocates, Haslam said, but he urged Shumlin to give supporters of health reform something “worth fighting for.”
