by Alice Dubenetsky
When Governor Peter Shumlin signed H.R. 202, the Green Mountain Care bill into law on May 26th, he made good on his campaign promise to move Vermont toward a single-payer health care system. However, there are more questions than answers surrounding the new law, including how the new system will be funded, whether ERISA laws block the state from imposing Green Mountain Health Care payroll taxes on businesses who already offer comprehensive health coverage (thus thowing a huge wrench into the (“everybody in, nobody out” financing strategy) the lack of residency requirements for coverage, and the effect the law will have on the business and health care communities. Speculation and supposition are rampant on both sides of the issue.
According to proponents of the bill, most of the questions will be answered by a five-member Green Mountain Care Board, which is scheduled to begin its work on October 1st of this year. The board will be appointed by a nominating committee of nine, who themselves have been appointed by Governor Shumlin, House Speaker Shap Smith, and the Senate President Pro Tem John Campbell.
James Eckhardt (R-Chittenden), a member of the House health care committee is troubled by the provision in the new law that schedules the release of the financing plan for 2013 – the year after the next election. Eckhart said the plan has been laid out so that implementation studies will be conducted in 2012, but financing proposals won’t be revealed until 2013, which does not give Vermonters the opportunity to consider the financing proposals when they cast their votes in 2012. He is among a growing contingent of Vermonters pushing to have the funding proposals revealed in 2012 – before the election.
Vermonters for Health Care Freedom, an independent not-for-profit organization, is currently circulating a petition demanding that the deadline be moved up. Their website charges the Governor and the legislature with “creative politics” and contends that Vermonters have begun to “wise up to their game”, admonishing Shumlin to realize that he is dealing with the real world, with real money.
Eckhardt feels strongly that the state’s health care system needed some kind of reform, but he expressed frustration with how quickly this bill was passed. “We should have done it in two or three sessions, not rammed it through,” he said, adding that it “came in on an “agenda train” and it wasn’t going to change with only three Republicans on the eleven person health care committee, especially since he believes that many of the committee members simply hate health insurance companies..
As far as residency requirements are concerned, Eckhardt said “there are none.” There is no definition regarding who can be served by the new law, or how long they must have lived in Vermont before becoming eligible for treatment under the Green Mountain Care program. Furthermore, there are questions about how Vermonters will be covered if they require medical care while in another state.
One the opposite side of the issue is Representative Michael Fisher (D-Lincoln), also a member of the House Health Committee, who has long been an enthusiastic supporter of single-payer health care. “I voted for it because it set us in the direction to make the system more rational, to weed out duplication, waste and fraud,” said Fisher during a recent conversation. He feels the current system is unfair and that the 5 billion dollars Vermont currently spends on health care is unsustainable.
Fisher acknowledges that the business community is divided over the health care issue, but he maintains that the system won’t survive without a complete overhaul. “It doesn’t matter how good your employer’s insurance plan is if community hospitals can’t survive (due to spiraling administrative costs).”
Fisher recognizes the concerns Vermonters have regarding the new law, but is confident that when it is finally implemented in 2017, it will provide better care for all at a lower cost. “Health care is very personal and it brings up a lot fear,” he acknowledged. But he also hopes it will open up a lot of opportunities and that, potentially, businesses would find it attractive to locate in Vermont because of Green Mountain Care.
Eckhardt , who is a businessman himself, strongly disagrees that Green Mountain Care is going to attract new business. In fact, he sees the opposite happening and says he wishes the Vermont legislature would “stop with the ideology”, citing them for being more concerned with pleasing social services than with helping to advance the business community, who they see as a cash cow. “A business would have to be moronic to locate in Vermont now”.