Vermont Health Care
Issue Overview: During the 2005 legislative session, the General Assembly passed a bill that would have established a government-run, taxpayer financed health-care system. Governor Jim Douglas swiftly vetoed the bill for 11 specific reasons.
There were two distinct issues that faced the Vermont General Assembly, however, and they were intertwined. The first is the ongoing Medicaid deficit; currently surpassing $80 million and the other was the affordability and access to health insurance.
A number of third-party groups banned together during 2005 to develop alternative proposals to a government-run, tax-payer financed plan. Coalition 21: An organization formed in 2004 to build consensus regarding how to transform Vermont's health-care system established six principles that were utilized by most advocates of health care reform as measuring stick for alternative proposals.
- Universal access to essential health-care services.
- Coverage for care that is comprehensive and continuous.
- Continuous improvement of health-care quality and safety.
- Health-care financing that is sufficient, equitable, fair and sustainable.
- Built-in accountability for quality, cost, access and participation.
- Engagement of all Vermonters in healthy lifestyles and informed use of the system.
Gov. Douglas promoted a health-care reform package during the 2005 and the 2006 session and worked with health care reform proponents to pass the Catamount Health Care plan.
NFIB Position: NFIB/Vermont supports legislation that would provide for greater access to lower premium health-care plans for small business. We support legislation that will facilitate the sale of health savings accounts and provisions of law that will reduce the overall cost to the health-care system without adding a higher level of burden to small businesses.
NFIB opposes a tax-payer financed, government-operated health-care system and opposes a tax increase as a way to finance a new system.
Issue Status: In 2006, the Vermont General Assembly passed and the governor signed into law the Catamount Health plan, a new health-insurance program intended to cover an estimated 25,000 Vermonters who are not now insured. This plan will join the other public health-insurance programs offered in Vermont, Medicaid, Medicare, and VHAP (Vermont Health Access Plan), adding at least $60 million to the state's $1 billion-plus cost of current health programs. The new insurance program is to be provided by private insurers.
The plan will be funded by Vermont taxpayers, an increase in the cigarette tax (80 cents a pack), employers will pick up a significant share through an employer assessment, and the newly insured will be required to pay on an income-based scale (ranging from $60 to $400 a month in premium). By 2010, in addition to the premiums paid by the newly covered employees, the new charge to employers will total at least $93 million, of which $59 million will be contributed by Vermont's smokers.
Catamount Health requires employers to pay a quarterly fee on all employees who are "uncovered" as defined in that law. Effective April 1, employers must begin reporting and paying an assessment on uncovered employees beginning with the filing of the Employer's Wage and Contribution Report (form C-101) for the second quarter of 2007, which will be due by July 31.
Two other components of the health care debate included the passage of legislation that establishes a pilot program to allow for a safe apology, so that an apology by a health-care provider would be inadmissible in court as an effort to prioritize the patient's health over litigation. A number of common-sense initiatives were also included.
These initiatives include healthy lifestyle discounts, wellness programs, medical event reporting and patient safety improvements, common claims forms, and provider credentialing, and provides some transparency of costs associated with health-care services to consumers; were advocated by NFIB/VT along with a number of other business organizations. These provisions, however, do not have specific implementation dates, so continued advocacy is required.
What to Do: Gain an understanding of the implications of this legislation passed in 2006, and discuss your concerns with legislators.
- Urge them to repeal the employer assessment.
- Urge them to oppose tax increases and tax expansions of any sort.
- Urge them to implement the common-sense initiatives, which are cost-containment measures to address the increasing cost of health care.
- Urge them to oppose further reform measures that move the Vermont closer to a single-payer, taxpayer-financed system.
