Report from Montpelier: Update on healthcare

By Rep. Kate Webb

A healthcare reform bill developed in January stalled in the House due to sticker shock as well as conflict over sources of funding. Over the past few months, members of the House have worked to find a way to reduce the amount of funding needed while continuing to fund those programs found to be most effective in improving health and reducing costs. A bill expected to be on the floor for debate either this week or next includes the following:

Vermont Health Connect: Vermonters have grown very weary of the continuing challenges plaguing the Vermont Health Connect website. A simple change in marital status or the birth of a baby could result in someone lost in the system for months. While the new company, Optum, does seem to be making progress, the House Healthcare Committee voted unanimously to set specific time limits on how long the State would continue to try to fix the troubled system. The bill requires a functioning technology by May 31, 2015 and a fully automated system by Oct. 1, 2015 in preparation for 2016 enrollment. If Vermont Health Connect fails to meet these milestones, the bill requires a transition plan to an alternative system such as the federally supported State-based marketplace.

Primary Care Reimbursements: Primary care providers are the most cost-effective resource we have; however Medicaid payments account for only 60 percent of the cost for services. The bill provides for increases in those rates, picking up a federal match of $1.10 for every state dollar invested. Increasing these reimbursement rates enhances access to the health care system for Medicaid patients and supports providers treating some of our most vulnerable citizens. In addition to increasing Medicaid rates, the bill provides $700,000 of annual education loan forgiveness to encourage primary care practitioners to practice in Vermont.

Blueprint for Health: This successful program focuses on primary care and preventative medicine moving Vermont from reactive to proactive health care, particularly for those with chronic health conditions. By coordinating services and resources at the community level, the Blueprint has proven to save money and improve outcomes. Every dollar spent for the Blueprint is matched by $1.15 in federal funds.

Green Mountain Care Board: This board has proven very effective at reducing the rate of growth in Vermont hospital costs. Funding here allows the Board to continue its work to establish rate setting necessary to pursue the All-Payer model, a system focused on improved outcomes rather than quantity of care.

Current Funding Package (subject to change): Down from $54 million to $8.8 million for FY 16 and $11.9 for FY 17. If passed as is, expect to see the following: 1) the sales tax applied to soda and candy: 2) an excise tax of 9 percent on vending machine purchases; 3) an additional 10-cents cigarettes this year and 23-cents the following. As part of the sales tax also goes to the education fund, this tax would also help reduce the non-residential property rate by 1-cent.

Please feel free to contact me: kwebb@leg.state.vt.us or (802) 233-7798. I am usually available to meet on Mondays in the Shelburne area, and Tuesday-Friday in Montpelier.