VTDigger: Senate budget leaves out health reform proposals


MONTPELIER >> Health reform proposals are in limbo after the Senate Appropriations Committee decided not to include funding for them in the overall budget bill it proposed to the Senate on Monday.

The budget that went before lawmakers Monday night did not include recommended funding to study a proposal to expand Dr. Dynasaur insurance to everyone under age 27, or to study Dr. Deb Richter's proposal to provide universal primary care to Vermonters.

The budget included about $250,000 for the Joint Fiscal Office to facilitate an independent review of Vermont Health Connect — a decrease from the $400,000 the House requested.

The budget did not include another $250,000 suggested by the Health and Welfare Committee to create a five-member board, the Health Research Commission, that would facilitate the studies.

The budget included tentative funding for four positions to create a rate-setting division within the Green Mountain Care Board. The money can be released only if the state receives a waiver from the federal government and then the Emergency Board approves the funding.

Sen. Jane Kitchel, D-Caledonia, chair of the Senate Appropriations Committee, said funding for the studies and the Health Research C0mmission will be dealt with when the Senate takes up H.812, this year's omnibus health care bill.

Senators could also choose to fund the studies before the budget bill gets final approval, or the House could choose to go to a conference committee to regain funding for the health care reform studies.

Peter Sterling, who led a campaign of nonprofit lobbying organizations that sought to fund the Dr. Dynasaur 2.0 proposal, said: "I appreciate that the House took steps toward studying affordable health care to more Vermonters, and I hope the Senate decides to do the same thing."

Al Gobeille, the chair of the Green Mountain Care Board, said it didn't make sense for the Legislature to fund the four new positions outright because there is always a chance that the deal with the federal government to allow an all-payer model in Vermont could fall through.

He said the tentative nature of the deal created a dilemma where the state could either commit to fund four new positions — which include a lawyer and several analysts — or decide not to fund the positions and stop negotiating to set up the all-payer model with the federal government.

"Neither one of us wanted to raise taxes for positions that may not be needed, and so I think that Jane (Kitchel) found an elegant solution," Gobeille said. "Not an easy one, but an elegant one. If that's the lens you're looking at it through, then she found an elegant way to do it."

Sen. Claire Ayer, D-Addison, chair of the Health and Welfare Committee, introduced an amendment on the Senate floor Monday that would require the Agency of Administration to study universal primary care without requiring any new money from the budget.

Ayer said universal primary care "is one of the very few things that is proven to reduce health care costs over time." She withdrew the amendment and said she would present it Tuesday.


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