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Federal stalemate hampers state health care reforms

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Posted on February 18, 2010 |
By John Flowers



MIDDLEBURY — While the Vermont Yankee nuclear power plant and a tight state budget continue to generate most of the headlines out of the Statehouse, lawmakers continue to work quietly and methodically on another major issue: Health care reform.

Local lawmakers provided an update on further health care reform efforts at Monday’s legislative breakfast at the Middlebury Legion.

Rep. Steve Maier, D-Middlebury, said the House Health Care Committee, which he chairs, has spent the past few weeks receiving testimony from Vermonters on various bills designed to improve health care coverage in the Green Mountain State.

But he noted the state’s efforts in making new progress in health care reform have been somewhat hampered by a lack of action on the issue in U.S. Congress.

“It had certainly been my hope that by now we would have the federal legislation passed,” Maier said, alluding to an ever changing national health care reform proposal that has stalled in the nation’s capital.

He noted that U.S. Sen. Bernie Sanders, I-Vt., has proposed legislation that would allow states to set up health care pilot projects with some federal support. That could allow states like Vermont to consider new reforms without the fear of running afoul of national policy, supporters noted.

“I refuse to lose all hope that something will happen there,” Maier said of federal health care efforts, “but our clock is ticking in Montpelier. In the last couple of weeks we have been trying to pull together a two-part plan on what we can do without the federal reform and then be ready to move if indeed that legislation passes as well.”

Maier said those involved in the health care debate in the Statehouse seem to agree that every Vermonter should have good health care and that industry costs need to be brought down.

Accordingly, Maier is trying to steer his colleagues toward legislation that encourages cost-containment and “a real commitment that Vermont will achieve universal coverage for every Vermonter, perhaps within the next five years.”

Middlebury resident Ellen Oxfeld was among several participants at Monday’s breakfast who urged the Legislature to adopt a single-payer, universal health care system. She argued such a system could save the state millions of dollars annually in hospital administrative costs, by getting rid of duplication and multiple billing through private insurance companies.

“If we are interested in cost control, we should really be looking at the single-payer model much more seriously,” Oxfeld said.

Maier said he does not believe Vermont could proceed with a single-payer system in the absence of the Sanders amendment and/or a federal health care bill.

“We still have Medicare, we still have Medicaid and we still have self-insured plans that would still create multiple players within the system,” Maier said.

Oxfeld noted that the Sanders amendment, if passed, would not take effect until 2017. Current signs point to 2014 as the earliest point at which federal health care legislation could kick in, according to Oxfeld. She suggested Vermont pursue its own federal waiver for a single-payer system before a national health care bill takes effect.

But some legislators pointed to the risk of Vermont going it alone.

“As a legislator, I have to support something that can work,” said Lincoln Democratic Rep. Michael Fisher, vice chairman of the House Human Services Committee. “I can’t just say I support something without an approach to doing it.”

Fisher believes if Vermont were to proceed unilaterally with a single-payer system, it could open itself up to a financial catastrophe if even a small number of needy patients from surrounding states move in to receive benefits.

“As a single-payer advocate, I don’t have an answer to that,” Fisher said.

Weybridge resident Fran Putnam suggested Vermont examine new health care regulations enacted in Massachusetts in 2006. The Bay State currently requires that all of its citizens obtain health insurance coverage. Maier noted that 97.5 percent of Massachusetts residents now meet that criteria, with the state providing subsidies on a sliding scale for those who cannot get coverage through their employers.

Maier said his committee has been looking carefully at Massachusetts’ plan, which has come in for some criticism.

“The problem in Massachusetts is that they mandated that people buy insurance without really focusing on the cost side,” Maier said. “They are actually having a significant budget problem being able to sustain and afford the program that they have.”

Lawmakers acknowledged that Hawaii has also achieved universal coverage through a state mandate that employers extend coverage to their workers. But Maier said that Hawaii, like Massachusetts, is experiencing financial problems with its program.

Other topics addressed at Monday’s legislative breakfast included:

• Agriculture, and a visit by U.S. Secretary of Agriculture Tom Vilsack to Vermont last Saturday (see related story, Page 1A).

• The future of Vermont Yankee. The issue, which headlined last week’s breakfast, took a new twist on Tuesday when Senate President Pro Tem Peter Shumlin, D-Putney, announced that the state Senate will vote before its town meeting break on whether “re-licensing the Vermont Yankee nuclear power station to operate beyond its scheduled closing date (of 2012) is in the best interest of Vermonters.” The Vernon-based plant is seeking re-licensing beyond 2012, a process that has come under increased scrutiny in view of recent evidence of leaking radioactive-laden water at the Vermont Yankee property and the fact that plant owner Entergy said there were no underground pipes carrying water until the leaks surfaced.

“I think there is a growing consensus among Vermonters that we need to close the plant down, and we have that firmly in mind,” Maier said at Monday’s breakfast.

Fueling concerns is the fact that, according to Maier, Vermont Yankee’s owner have assembled only half (roughly $400 million) of the needed funds to properly close the plant.

“We are trying as hard as we can to focus on that issue before we vote to close the plant down, so that we can try to get as many of those issues resolved before we lose our bargaining positions and authority over closure of the plant,” Maier said. “My guess is that it is going to be very difficult for us to secure all of those closure funds if we indeed close it down by 2012, which is where I think we seem to be headed.”

• Education funding. Residents voiced frustration about rising education property taxes in spite of level-funded school budgets.

• The state’s budget woes. With a $151 million deficit looming for fiscal year 2011, lawmakers said human service programs for children and the elderly are among those on the chopping block.

The next legislative breakfast, sponsored by the Bridport Grange, will be held Monday, Feb. 22, at the Orwell Firehouse. Breakfast starts at 7 a.m., with the program commencing at 7:30 a.m.

Reporter John Flowers is at johnf@addisonindependent.com.

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