“We are heading in the wrong direction,” Lisman said. “Vermonters are really tired of being experimented upon. They don’t want to hear that we are first in the nation in anything related to health care, except having affordable, accessible and quality health care.”
Lisman pointed to state Medicaid audits in Rhode Island, Oregon and North Carolina, where millions in potential savings were identified, and said Vermont would do well to conduct a similar study.
He said a Vermont audit could reveal Medicaid recipients who didn’t qualify and answer whether all of the state’s offered benefits are being used. Lisman promised to provide support for vulnerable Vermonters who could lose benefits under his proposed Medicaid reforms, but he didn’t provide details.
“Why wait for daylight when we can turn on the lights now to find out where we are in the room?” he asked.
In North Carolina, auditors found potential for $180 million in savings over a biennium.
More than $200 million was overpaid to insurers in Rhode Island’s expansion of Medicaid under the Affordable Care Act after administrators overestimated the services that recipients would use.
Lisman said he wasn’t sure how much money could be identified from a Vermont audit but that the savings could be significant.
A recent editorial by the Providence Journal about the Ocean State overcharges cast blame on several actors, including Steven Costantino, who served as that state’s secretary of health and human services.
In February, Costantino left Rhode Island to become commissioner of the Department of Vermont Health Access.
Lisman repeatedly called the Shumlin administration’s health care leadership “incompetent” in the news conference, echoing the rhetoric in two ads the former Wall Street executive rolled out against the governor this week.
The state’s Medicaid costs are rising quickly, from a $1.1 billion program in fiscal year 2008 to a $1.7 billion program in fiscal year 2016.
The increased spending is a result of many things, including rising costs of prescription drugs, changes in federal funding, the aging of Vermont’s population, and an increase in the number of adults age 18 to 64 who qualify for Medicaid.
More than $25 million in Medicaid money has been allocated to help fight addiction to opiates and other drugs in the state.
VTDigger’s comprehensive breakdown of Medicaid spending can be viewed here.
In other cost-cutting proposals, Lisman called for transitioning away from Vermont Health Connect to the federal health insurance exchange.
He said he wasn’t sure how much it would cost to move to the federal system but asserted that “it’s going to be cheaper than continuing on the path we are on now.”
The Shumlin administration continues to defend the state system and said Wednesday that its long-term plan to fix it includes removing a dysfunctional piece of software that the system currently relies upon.
The House Health Care Committee has recommended that the Joint Fiscal Office facilitate an independent review of Vermont Health Connect since Feb. 26, but the governor remains opposed to independent review.
Lt. Gov. Phil Scott, Lisman’s Republican primary opponent, has also expressed support for switching to the federal health exchange.
