Video of Gov. Peter Shumlin’s news conference May 13, 2015, provided by Vermont PBS.
[L]awmakers in a committee of conference are working to iron out the details of a health care package Gov. Peter Shumlin dismissed as “mighty slim” in remarks Wednesday.
Shumlin, who is pushing for more budget cuts, said he wants to be “cautious” about raising taxes for anything other than balancing the budget, now that lawmakers have rejected his $90 million payroll tax package for health care initiatives.
The governor did not go so far as to say he doesn’t think the health care package is worthwhile, but said what’s under consideration is a far cry from what he proposed in January.
The story of health care reform this legislative session is one of diminishing ambition. Before lawmakers gaveled in, Shumlin had abandoned plans for a single-payer system, and the appetite for sweeping action faltered from there.
The governor’s $90 million payroll tax to pay for health care programs never gained traction, and legislative proposals shrunk from $52 million to $20 million to the current $12 million.
Members of a health care conference committee met several times Wednesday to work on reconciling their versions of S.139, the health care bill.
Rep. Janet Ancel, D-Calais, chair of House Ways and Means and a member of the health care and tax bill conference committees, said while there are differences in spending priorities and how the money is raised, the two bodies “aren’t that far apart” when it comes to how much money to spend.
The House bill raises $11.9 million in a full fiscal year, and the Senate bill raises $10.68 million. Much of that spending is eligible for federal Medicaid match, bringing the total spending to $19.2 million in the House version and $22.2 in the Senate version, which has more match-eligible spending than the House proposal.
Sen. Jane Kitchel, D-Caledonia, a member of the health care and budget conferences, said the most controversial aspect of the divergent health care packages are the taxes to pay for them, which will be decided in the tax bill conference committee.
That’s because the Senate tax increase for health care is in the tax bill, as are some of the taxes in the House health care package — except in the Senate tax bill they support spending in Senate-passed budget bill.
Ancel and Sen. Tim Ashe, D/P-Chittenden, sit on both the health care and tax conference committees and are likely to play pivotal roles in deciding which taxes will pay for health care.
The House version relies on a combination of sales taxes on candy, soda and vending machine meals, as well as increases to the cigarette and tobacco taxes. The Senate version uses a tiered increase to the employer assessment, a per employee tax on businesses that don’t offer a health benefit, whose employees don’t take the benefit or for employees on Medicaid.
The House version invests more heavily in subsidies to reduce out-of-pocket-costs for middle- and low-income people in Vermont Health Connect, as well as payments to providers in the Blueprint for Health managed care program; the Senate spends more on targeted increases to Medicaid reimbursement rates.
Both versions contain many of the same policy provisions, including those expanding the role, authority and budget of the Green Mountain Care Board. Both versions also have provisions contained in S.139 as it was introduced, which offer greater regulation of pharmacy benefit management companies, and requires hospitals to notify patients who are placed on observation status about whether Medicare covers the service — a practice that has resulted in unexpected costs for beneficiaries.
However, policy differences between the two proposals were still unresolved Wednesday evening when the conferees broke for the day. None of the spending or tax provisions were reconciled Wednesday night.
The conference committee is expected to meet again at 8:30 a.m Thursday. The package is likely to be finalized by the end of the day Thursday or possibly Friday.
For a detailed comparison of the two bills click here, and for a chart comparing the spending and revenue that support each click here.
