Bills have moved quickly during the last two weeks through the Vermont House, including passage of some very important bills: a Hospice and Palliative Care bill, the Miscellaneous Tax bill, the Appropriations bill, the Transportation bill, the Capital Construction bill, and the Unified Health System bill, the last being probably the most controversial of all. Because of its importance, and because there are so many misconceptions floating around abut it, I will devote this report entirely to H.202, the Unified Health System bill.
When the bill was introduced at the beginning of the session, it was given the title, “An act relating to a single-payer and unified health system.” The Health Committee spent weeks taking testimony from many different stakeholders in order to gain as many perspectives as possible. After a lot of revising, the resulting bill was brought to the floor and debated for 18 hours over two days before it was passed on March 24th.
H.202 is the beginning of an process to provide health coverage for all Vermonters. It will do 3 things:
1) create a Health Care Exchange, which will set standards for health coverage and allow Vermonters to compare and choose an insurance plan from the various plans being offered in Vermont
2) create the Green Mountain Care Board which will set goals for universal coverage including primary, preventative, chronic and acute care, and will determine the costs of providing that care, and develop methods for controlling costs and funding the health care system, and will report its findings to the legislature; and
3) create the Green Mountain Care program, which will eventually, after the details have been worked out, provide health benefits to all Vermonters.
The legislature will have to vote in subsequent years to accept the findings and to move to the next phase if warranted. The last phase would be to approve the funding to implement the plan and start enrolling Vermonters, and this would not happen before 2015. At each step, the legislature has the option of exiting this strategy. H.202 does not go all the way in getting the job done because it basically sets the stage for designing the system in a rational manner.
Some may ask why the Green Mountain Care program is included in the bill if it won’t be needed for several years. There are several reasons including:
· if we are serious about reform, we need to make a commitment to it;
· we are more likely to be successful if we provide clarity about the direction we want to go;
· it is easier to explore and receive federal waivers if we have a commitment in statute.
Finally, it is important to clarify what the bill does NOT do. It does not include a payroll tax; the method of financing will be determined during the planning phase. Nor will it supplant Medicare or employer retirement health plans, but will be secondary to them.
By the time this article is published, a forum on H.202 will have been held in Shelburne. I tried to get the word out via the Front Porch Forum, my website, emails, and posters. If you were not able to attend, there are plans to hold a similar forum in Hinesburg in the coming weeks. Keep an eye on this website for a notice. You may also find answers to some frequently asked questions here.
