[G]ov. Phil Scott’s appointment of a former government finance official to the state’s health care regulatory board is prompting pushback and may lead to new rules on its membership.
Scott recently installed Tom Pelham, a former independent state representative who served in four administrations, to fill an opening on the five-member Green Mountain Care Board.
Pelham is Scott’s third appointment to the powerful regulatory board, which sets hospital budgets and health insurance rates as well as regulating the expansion of health care infrastructure in Vermont.
The advocacy group Rights and Democracy is calling on the Senate not to confirm Pelham, a fiscal conservative, describing him as a “voice for more health care austerity” and saying he and the board lack “an everyday patient’s perspective.”
Rights and Democracy sent a letter to Sen. Claire Ayer, D-Addison, chair of the Senate Health and Welfare Committee, urging her to reject Pelham’s appointment. The group is also collecting signatures for a petition with the same call to action.
Pelham bristled at the group’s characterization of him, saying it ignores his role helping former Gov. Howard Dean create the financial capacity for his first Medicaid expansion and his work as a lawmaker to lower premiums for the Vermont Health Access Plan, a precursor to Vermont Health Connect.
“I just think, whoever this group is, they’re reacting to their own ideological biases and don’t know anything about my record,” Pelham said.
The Rights and Democracy letter points to op-eds Pelham wrote that are critical of Act 48, Vermont’s health reform law. Pelham argues that his concerns about the cost of reform efforts were validated when Gov. Peter Shumlin abandoned his single-payer push because it was too expensive.
The Legislature typically accepts governors’ appointments unless there are concerns about a person’s competency for the position.
While she may not agree with all of Pelham’s policy positions, Ayer said there is no doubt he is competent to serve on the board.
“My assumption is that we will go ahead and approve him,” Ayer said. “We try to honor appointments.”
That doesn’t mean Ayer approves of Scott’s choice. Ayer, a registered nurse, said she is disappointed the governor hasn’t selected anyone for the board with experience in the health care field.
“I wondered at first if Gov. Scott was looking to scuttle the board,” Ayer said, adding that she believes having a health care professional’s perspective is crucial to the board’s work.
Neither of Scott’s other appointments — former Sen. Kevin Mullin and finance executive Maureen Usifer, has a health care background. That’s led the Vermont Medical Society to call for a law requiring at least one member of the GMCB to have experience as a health care provider.
Ayer said she expects such legislation to get consideration this session and will be supporting it.
Scott spokeswoman Rebecca Kelley did not address the prospect of such legislation directly, but she said the board has been without a health care professional since Dr. Alan Ramsay left in September 2016. Shumlin chose to replace him with Robin Lunge, the architect of his health reform efforts, who does not have provider experience.
Kelley said medical providers are represented to the board through advisory groups, and Pelham has a similar public service background to Con Hogan, a former Agency of Human Services secretary who sat on the board.
“Generally, it’d be questionable to appoint an active utility executive to the Public Utility Commission, so there is a question about appointing an active health care provider to a board that has oversight of the health care system, which includes the provider community,” Kelley added.
Senate Secretary John Bloomer said Ayer is correct when it comes to precedent on confirming gubernatorial appointments.
The statute establishing the Green Mountain Care Board was modeled after that of the judiciary. Both rely on nominating committees whose membership includes representatives of all political stripes. The committees forward a list of qualified candidates to the governor, who makes the appointment. It’s then up to the Senate to confirm the appointee.
While there are no rules preventing senators from voting against an appointee for political or ideological reasons, Bloomer said he could not recall a single instance in recent history when the Senate rejected a governor’s judicial appointment. Bloomer had to go back two decades to recall a nonjudicial appointment that the Senate rejected, adding that it, too, is a rare occurrence.
In Vermont, unlike at the federal level, appointees serve pending their confirmation. That means Pelham is reporting for duty each morning to the GMCB’s Montpelier offices.
Pelham said is enjoying his new role. “It’s an exciting place to be,” he said.
