By Rob Roper
Perhaps the question of greatest concern for Vermont’s roughly 100,000 senior citizens regarding our legislature’s move toward a state-run, single payer healthcare system is, what’s going to happen to my Medicare?
The answer that the Shumlin Administration would like to placate seniors with is that Medicare is a federally run program, and it would require a waver that Vermont is not likely to get in order for our state to take it over. Nothing for you to worry about. Doesn’t concern you. Pay no attention to that law that’s now on the books (Act 48).
Although it’s true that the likelihood of a Medicaid waver is thin today, it is not entirely out of the realm of possibility – and it is something the Shumlin Administration would very much like to see happen. As such, Vermont seniors need to take a look at the language in Act 48 carefully.
The key passages in the 141-page piece of legislation come on pages 12 and 85. The law states:
The director, in collaboration with the agency of human services, SHALL OBTAIN WAIVERS, exemptions, agreements, legislation, or a combination thereof to ensure that, to the extent possible under federal law, ALL FEDERAL PAYMENTS PROVIDED WITHIN THE STATE FOR HEALTH SERVICES ARE PAID DIRECTLY TO GREEN MOUNTAIN CARE. Green Mountain Care SHALL ASSUME RESPONSIBILITY FOR THE BENEFITS AND SERVICES PREVIOUSLY PAID FOR BY the federal programs, including Medicaid, MEDICARE, and, after implementation, the Vermont health benefit exchange. (Page 12) [All emphasis added]
On page 85 the law states:
The agency SHALL SEEK PERMISSION from the Centers for Medicare andMedicaid Services TO BE THE ADMINSTRATOR FOR THE MEDICARE PROGRAM IN VERMONT. [All emphasis added]
What this means is that the Vermont state government is now required by law to fight as hard as it can to end Medicare in Vermont and to get the waivers needed to fold the people in that program, along with all the federal money that comes with them, into this pig-in-a-poke Green Mountain Care experiment. And, they will try. If only because the goal of the Shumlin Administration and the Democrat majorities in both chambers of the legislature is, of course, America’s first single payer system, and a single payer system won’t exist as long as the state is one payer and the federal government is a second.
In addition, seizing control of the millions in Medicare dollars that currently flow to Vermont seniors would go a long way to making what is a financially suspect plan more viable. As Anya Rader Wallack, chair of the Green Mountain Care Board, said in an interview with Kaiser Health News, “… We really need to include Medicare in all of the things that we’re doing around payment reform and delivery system reform, which will be the basis for our cost containment.”
But, what is the likelihood of Shumlin and the Democrats obtaining the federal waivers necessary to implement their desired plan? If Peter Shumin and Barack Obama are re-elected in November, the odds will improve exponentially. In 2003, Barack Obama said to the Illinois AFL-CIO, “I happen to be a proponent of a single payer universal health care program.” This was a sentiment he reiterated on the campaign trail in 2008. If this is the president’s ultimate goal, the next logical step would be a pilot project on the statewide level. Peter Shumlin has crafted Act 48 and Act 171 with an eye toward making Vermont the prime candidate for lab rat in this experiment.
The famous Russian playwright Anton Chekhov said never mention a gun in the first act unless it’s going to go off in the third. Act 48 introduced the loaded language aimed at Medicare in 2011. 2012 furthered the single payer cause in Vermont. Will the gun go off in Act III, 2013? Well, in this play, the voters get to decide the ending in November.