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SENATE MEDIA HIGHLIGHTS
Memo sent to the Governor on June 2, 2005
Senate plans expanded health plan, with fuller coverage 3 percent payroll tax to fund measure May 4, 2005 | By Ross Sneyd | The Associated Press
MONTPELIER — A Senate health reform plan has been expanded and offers the promise of providing both primary and hospital care within two years if the state is successful in driving down ever-rising medical costs.
But some of the ways those costs would be controlled may prove controversial, especially a provision that would give the state more authority over hospital budgets.
The primary initiative would remain unchanged: Those who do not have insurance would be able to qualify for a new barebones plan of primary and preventive care beginning next year to be funded by a payroll tax.
That's been criticized, especially by House Democrats who approved a much more comprehensive plan that set up the mechanisms for full coverage, as promising too little coverage.
So senators have been looking for ways to expand their plan while keeping it modest enough that they don't risk losing the governor's tentative support.
They think they've found a potential solution. They would offer the basic health plan and pay for it with a payroll tax of 3 percent on employers who don't currently offer coverage and employees who don't have insurance. They also would institute a number of measures designed to drive down costs, such as better use of technology.
If those efforts save enough, then a hospital coverage plan would be added as early as 2007.
"We're working off some of the good that was in the House and also trying to address some of the questions that were raised in the House," said Senate President Pro Tem Peter Welch, D-Windsor.
Senators are interested in providing "immediate access to primary health care and setting a timetable to achieve full health care coverage for all Vermonters by meeting benchmarks on controlling costs," Welch said.
Like the House, the Senate is dominated by Democrats. But Senate leaders have found themselves in the position of trying to maneuver between the ambitious taxpayer-financed health system proposed by the House and the much more modest proposal of Republican Gov. Jim Douglas, who would continue to rely on the private insurance market to expand coverage incrementally.
Sen. Edward Flanagan, D-Chittenden, is one of the senators who pushed for a much more aggressive approach to health care, but he has thrown his support behind the bill that's being written in the Senate.
"You have to deal with political and pragmatic realities," he said. "We have a governor threatening veto and we don't have a veto-proof majority."
But there could be more opposition to the bill as it is now developing.
Hospital administrators are especially alarmed at new language that would give the state broad authority over their hospitals. They fear that the state would have the ability to run the hospitals themselves because the state could order "the addition, consolidation or discontinuance of operations and services."
Administrators were organizing to testify against the plan later in the week.
Douglas has said he likes the direction of the Senate plan although he is opposed to the payroll tax provision. Senate leadership pushes its version of health reform legislation By Ross Sneyd, Associated Press Writer | April 27, 2005 MONTPELIER, Vt. -- Now that Senate Democratic leaders have found a health reform initiative that they believe can become law, they began rallying their forces Wednesday and trying to promote the bill even as they continue putting it on paper. A one-page outline of their plan was released only a day earlier and the formal bill that would put those ideas into law still has not been completely drafted. Nonetheless, senators are treating it as the elusive compromise that would bridge vast differences between Gov. James Douglas and the much more ambitious House Democratic plan. "This is not a revolution. This is building a plan step by step, brick by brick, the bridge to somewhere," said Senate Health and Welfare Committee Chairman James Leddy, D-Chittenden. That's a message that senators are eager to continue sending: They view their bill as a bridge to a more comprehensive reform effort. That's important because their colleagues in the House last week adopted a bill that would eventually impose millions, perhaps billions, of dollars in taxes to fund a taxpayer-funded health care system. Senate leaders say theirs would begin moving toward that goal by raising about $40 million in payroll taxes, which would be paid only by employers who don't currently offer their workers insurance, and by the employees who don't have it. Both approaches would also begin to implement some cost-cutting measures, such as improving preventive care and chronic care and beginning to move away from the practice of paying hospitals and doctors for every service they provide. Instead, they'd be rewarded for providing the kind of care that makes their patients healthier. "The common goal, House and Senate, is to bend that (cost) curve," Senate President Pro Tem Peter Welch, D-Windsor, said. As more people get insurance coverage because the Senate would require health insurance, the state would get a sense of what cost-cutting measures worked and would set the stage for a more comprehensive system, such as the House proposed, he said. "There's going to be evidence here about whether that cost is coming down," he said. One of Welch's primary goals is finding a bill that actually can become law. It's clear Douglas would veto the approach crafted by the House, but he's showing willingness to work with the Senate. "I believe it is generally a lot more responsible than what passed the House of Representatives and I think the basis for agreement," Douglas said of the Senate plan during an appearance on Vermont Public Radio's "Switchboard." "I think we may well be able to find some common ground." Leaders of the House are keeping an open mind on the Senate's work, emphasizing that along with the Senate they are keen to slow the spiraling cost of health care. But there also are many in the building who are strongly opposed, especially some of the small businesses that drafted an alternative to the House bill and that Senate leaders used as a model for their own. A key difference between the bill drawn up by the National Federation of Independent Businesses and the Vermont Grocers' Association is that senators are calling for a payroll tax to pay for their plan. The businesses would have required all residents to buy insurance, but they would not have imposed a tax to pay for the coverage. "It boggles my mind that they think they can just throw money at this," said Shawn Banfield, a lobbyist for NFIB. "We would rather incent employers to offer programs rather than mandate it with a pay or play payroll tax," said Jim Harrison of the grocers. April 27, 2005 | Rutland Herald | By John Zicconi, Vermont Press Bureau MONTPELIER — The state Senate on Tuesday outlined a health care reform plan that would provide primary care coverage to the state's 63,000 uninsured by July 2006, but falls far short of providing universal coverage to all Vermonters. The proposal calls for a 3 percent payroll tax on businesses that do not provide employee health benefits and on workers who do not have health insurance. The tax system would work much like Social Security, as employees would have a deduction taken from their paycheck and their employer would match that payment. Businesses that have employees who receive health coverage through Medicaid's Vermont Health Access Plan for the working poor would also have to pay the tax, which could be levied as early as January and raise nearly $40 million annually. "This does not hit businesses that are already providing health insurance," said Sen. James Leddy, D-Chittenden, chairman of the Senate Health and Welfare Committee. Leddy said the Democrat-controlled Senate's goal is to provide full health coverage to all Vermonters. But until a detailed plan is developed on how to do that in a way Vermont can afford, senators want to provide at least primary care coverage to all, he said. "This is not the total that any of us want," Leddy said. "But it is a first step." The Senate's go-slow approach to providing universal access to health care is a direct response to Republican criticism leveled at a partisan reform plan passed last week by the House. Gov. James Douglas has suggested he would veto the House plan, which calls for the immediate reorganization of state government. That plan would create a publicly financed health care system by 2007, even though no one has identified how much it would cost or whether the state can afford it. The Legislature does not have the votes to override a veto, so the Senate is trying to develop a plan that immediately provides at least partial coverage to the uninsured that Republicans can support. "This is both a substantive and political attempt to deal with some of the difficult realities in front of us," said Sen. Edward Flanagan, D-Chittenden and a member of the Health and Welfare Committee. Committee member Sen. Kevin Mullin, R-Rutland, praised Senate leaders for addressing what all lawmakers believe is an important issue in a bipartisan fashion. "We are trying to work together," Mullin said. "We are working in the spirit of compromise and trying to come up with something everybody can live with. We still have a long way to go … I'm not jumping up and down for joy. But I am encouraged." Gubernatorial spokesman Jason Gibbs said Senate President Peter Welch, D-Windsor, met Tuesday with top administration officials to discuss the plan. Although it is too early to tell whether Douglas supports the idea, he is listening, Gibbs said. "The governor is very grateful for Sen. Welch's willingness to work with him," the spokesman said. "But we are unable to comment on the specifics until we have had a chance to look at the plan much more closely." Senators have yet to write a bill. The proposal floated Tuesday was only an outline. Health and Welfare Committee members said they hope to detail the plan this week and on Friday move a bill to the Senate Finance Committee, which will develop how the taxing scheme would work. The outline breaks the uninsured into two categories: 35,000 who lack any kind of insurance means and 27,000 who qualify for Medicaid, but have not enrolled. The plan calls for the Medicaid eligible to enroll in that government-sponsored program, which receives 60 percent federal funding, and create a new state-run, primary-care insurance program for the others. Senators believe the state can develop a primary-care package for 35,000 residents at a cost of $1,500 per person. Welch said Senate committees over the next two weeks will also develop health care cost-containment strategies. But unlike the House plan, the legislation will not call for the reorganization of state government or implement universal access until the their economic impacts are studied and better understood, he said. House Speaker Gaye Symington, D-Jericho, said she looked forward to seeing the finished product. "The House had time to do its work, now the Senate needs the same space," Symington said. "It's clear from this outline that we are on the same page. … But I need more time to understand it better before I can comment." Vermont Initiative for Universal Health Access EMAIL: wsavt@wsavt.com All rights reserved |
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