Lawmakers won’t see a plan to finance single-payer health care until 2015. But even as the Legislature tries to speed toward a Saturday adjournment, the issue of health care funding continues to loom large. And some lawmakers are ramping up efforts to create an alternative to single-payer.
At the beginning of the year, a group of mostly Republican lawmakers went to a legislative analyst and posed a question: Is there a way for Vermont to abandon single-payer but still achieve all the health care benefits that Gov. Peter Shumlin has promised to deliver to residents?
“Which include universal coverage, access to quality care and cost containment,” said Arlington Rep. Cynthia Browning. “And we wanted to be able to achieve those goals. But we thought it might be possible to make progress without going all the way to public financing.”
Browning, the lone Democrat in the group, said work with the analyst has yielded an attractive alternative. The plan would, at a broad level, maintain the private insurance market, allow for plans to be sold outside the new online exchange, and increase state subsidies to low- and middle-income Vermonters who otherwise might not be able to afford insurance.
Browning said the proposal comes with an annual cost of about $30 million.
“It doesn’t require redoing how insurance is provided or how it’s financed,” Browning said. “It doesn’t require redoing our tax code. It doesn’t require raising $2 billion or even $250 million.”
House Minority Leader Don Turner said the document should not be viewed as a proposal from the Republican caucus. And he said there’s plenty in the plan that his members might find troublesome, such as the tax on health benefits that would be used to fund the new expenditures. But Turner said that although it’s up to Shumlin to deliver a plan, the GOP is contemplating other approaches to health care reform.
“We felt that since the Legislature had hired this expert (who) had worked with the state of Vermont in the past, that we would try to work in a bipartisan manner to try to achieve the goals that were laid out in Act 48, understanding that we fully believe that a more robust marketplace is where we want to go,” Turner said.
Shumlin says he isn’t ready to show Vermonters how he’ll pay for single-payer. But Windham Sen. Peter Galbraith raised some eyebrows a week ago when he told his colleagues not only is the governor’s financing plan nearly complete, but that he’s gotten a look at it.
“It comes to me from a source that is not in the administration, but I have a great deal of confidence that this does in fact reflect the thinking of those in the administration,” said Galbraith, a Democrat who this year proposed using an 11 percent payroll tax to fund single-payer.
As was reported first by VTDigger.org, Galbraith said the Shumlin plan would use a combination of a 5 percent payroll tax, a 2 percent tax on fuel gross receipts and a mandatory premium that would be equivalent to a 9 percent income tax on people making $50,000 a year and more, with a maximum cap.
Administration Secretary Jeb Spaulding wouldn’t comment Wednesday on whether any aspects of Galbraith’s assertions are based in fact. But, he said, he can “state quite certainly that some of the pieces Galbraith says the governor is thinking about, he is not anywhere near thinking about doing those.”
Browning said her plan doesn’t ensure health insurance as a right of Vermont residency, something Shumlin has insisted is an essential component of any health care reform initiative. But, she said, according to the administration’s own projections, the number of uninsured Vermonters will soon drop below 15,000, largely because of increased Medicaid eligibility as a result of the federal Affordable Care Act. And, she said, it doesn’t make sense to upend a system that works for many Vermonters when policymakers could take a more surgical approach to finding and enrolling the uninsured.
“To my mind, this is a modest reliable alternative path for health reform that builds upon what we’ve already got and uses what’s already going right,” Browning said.
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