MONTPELIER — House and Senate Republicans have accused Gov. Peter Shumlin of violating state law by failing to tell Vermonters how he plans to pay for single-payer health care.
Legislation that the Democratic governor signed in 2009 included a provision calling for the recommendation of a single-payer financing mechanism by Jan. 15 of this year. Administration officials say the mandate was rendered unnecessary by a shifting federal landscape that postponed for at least three years any hope of implementing the publicly financed system.
Senate Minority Leader Joe Benning, however, said Vermonters are looking for answers, not excuses.
“Businesses need to have the information necessary to make important decisions for themselves and their employees,” Benning, a Caledonia County Republican, said during a Statehouse news conference Thursday. “We need to have a clear understanding of what the game plan is, and at present we don’t have that game plan.”
Administration Secretary Jeb Spaulding dismissed the criticism as a “stunt.” The administration last week unveiled a highly anticipated report on single-payer; Spaulding said the administration had explained to lawmakers in advance that it would not include any specific recommendations for financing. He said reasonable people agree that it makes no sense to design a financing system now for a program that won’t begin until 2017.
“These are people who want to undermine the effort to move to a single-payer system and are looking for any opportunity they can get to confuse people and erode support,” Spaulding said. “Issuing a specific plan at this stage of the game would not in any way help Vermonters understand what a new system would look like or what the options are to pay for it.”
Jeff Wennberg, executive director of Vermonters for Health Care Freedom, said Vermonters can’t begin to understand what the new system would mean for them until the administration discloses what tax it would use to finance the program.
The report issued last week put a $1.6 billion price tag on the portion of the single-payer plan that would need to be publicly financed. Wennberg, whose organization’s mission is to end the push for single-payer, said residents and businesses can’t evaluate the plan until they know how much of that bill they’re on the hook for.
“There is no analysis of the impacts on anyone,” Wennberg said. “There’s nothing remotely resembling a proposal or set of proposals, or what taxes would be necessary or needed to raise this money.”
While the lack of a financing plan is of chief concern to Wennberg, he said it isn’t the only area where the administration has fallen short. The single-payer law passed in 2009 also called for recommendations on how to deal with issues of coverage for nonresidents living in Vermont, or for residents living out of state.
It also directed the administration to study issues around recruitment and retention of the health care workforce. In all, Wennberg said, the administration failed to deliver on at least 15 statutory directives.
Of particular concern, he said, was the administration’s failure to comply with the portion of the law that required it “to determine the potential impact of various financing sources on Vermont businesses and on the state’s economy and economic climate.”
The administration had as recently as last summer looked poised to deliver that analysis. When the administration in July inked a $300,000 contract with the University of Massachusetts Medical School, the deal called for not only developing a financing plan but performing an “analysis of the interaction of new provisions with Vermont’s current revenue structure, including income, property and sales tax, and recommend(ing) possible complementary reforms to the overall tax code.”
The administration’s director of health care reform, Robin Lunge, said at the time that the contract with the university would provide a “deep dive” that would “dig into the pros and cons of financing options.”
“We need an analysis of the macroeconomic impacts, so we know that if we change financing in one way, we have a sense of how that flows out into the state’s economy,” Lunge said in July.
Asked why the report failed to include items stipulated in a contract signed six months ago, Spaulding said that “it didn’t seem like the right time” to examine deeply the cause-and-effect of various financing schemes, be it taxes on payroll, income, sales or anything else.
“It wouldn’t have been helpful now for Vermonters to issue a specific financing plan,” he said.
Asked whether the contract had been amended since it was signed in July, Spaulding said it had. He said he was unsure whether the revisions included eliminating the requirement to analyze the macroeconomic impacts of various single-payer funding streams.
In the face of Democrats’ near super-majority in Montpelier, the Republicans can take no legislative action over the lack of a funding plan. Wennberg’s group, however, has filed a broad public records request seeking all communication and correspondence between the state and the University of Massachusetts.
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