Saturday, April 7, 2018

April 7, 2018 Legislative Update


Heading into the final four scheduled weeks of the session, the focus in Montpelier has turned back to our committee work, taking up bills passed by the Senate. In House Health Care, the biggest bill we’re received is a proposal to evaluate creation of a universally accessible primary care system. The original bill that passed the Senate Health and Welfare Committee laid out the steps to create a publicly-funded system, with no co-pays, that gave every Vermonter access to primary care. Its statement of intent included that this was to be a first step towards reestablishing a path to a full single-payer health care system. (Medicare coverage would stay as it is, but the state would cover copays.)
The Senate Appropriations Committee got cold feet over the financial viability of the plan and reshaped it to be an evaluation of options for creating universal access, but not necessarily through public funding. Supporters of single-payer were aghast at the change, and some [not all] are saying they would prefer no action at all. We are already being inundated with emails urging us to go back to the original version of the bill.
There are some huge underlying challenges, and a fundamental bottom line. Our health care spending is heavily controlled by the federal government. We take in so much in federal “matching dollars” that we actually receive more than what we pay out in taxes. In other words, our neighbors in other states are subsidizing us. So striking out on our own is not an option. That is a big part of why Vermont’s vision of its own single-payer system was doomed to failure. That is also what moved us into our current health reform initiative, the “all payer” model that uses a single organization (called an accountable care organization) to funnel money from payers into the health care system to make it more streamlined, with better coordination of care.
It wasn’t based on own choice to pick that system. The federal government set it up for its own Medicare program, and we latched onto it with Medicaid to try to align systems. As private insurers join in, it has some real potential for managing our unwieldy system. It’s in its infancy and it still hard to tell whether we can actually get the Titanic to shift course. Having put at least some of our eggs into that basket, however, raises serious questions for me about whether we can overlay a second major change on top of the first one while it is still just getting off the ground. The broad concept for the new proposal isn’t very hard to grasp: if the state funds primary care for all, everyone’s insurance rates go down – your insurance is left only covering higher levels of care – so the cost savings is transferred to the new system.
However, in the new all-payer model, the ACO is being paid to provide all health care, including primary care. A person is attributed to the ACO’s payment model based upon being the patient of a participating provider. If all primary care doctors became part of a single-payer primary care system, the ACO role might become superfluous for primary care, yet it would need to remain for everything else, plus coordinate between systems. The more that we increase the shuffling of money between different entities and payment mechanisms, the more some of it gets lost in the transactional costs. If the major focus is making sure everyone has access to primary care, another route might be to focus solely on those who currently don’t have access, instead of creating a whole new system. That includes those without insurance, but also folks who can only afford insurance with very high copays and deductibles.
There is very strong evidence that getting good primary care saves in overall health care costs. Illnesses are intercepted earlier and are easier and less expensive to treat. People stay healthier. The evidence is more mixed over whether copays are still a barrier to getting care even if they are low, and thus should be eliminated, or whether they are a protection against overuse of care.  How much is it appropriate to have people hesitate (“Is this worth a $20 copay?”) before heading to the doctor? Obviously striking the balance is very dependent upon individual incomes (what percentage of your paycheck is that $20?) I’m not sure I buy into the idea that the ideal system would have no individual contribution at all for getting care – no “skin in the game.”
The bill that eventually passed the Senate includes evaluating the question of copays rather than starting with the assumption of a system without them and requires looking into methods other than a publicly-paid system to ensure everyone has access. Two questions will be before our committee. First: whether doing a major evaluation of options and mechanisms are likely enough to provide solid outcomes to be worth the cost. Second: whether we should be returning to some form of the original Senate bill and plunge forward with trying to make this happen, faster.

Legislative Update, Part 2
Pharmacy Costs
We are also grappling with the costs of prescription drugs. Specialty drugs are becoming the biggest new cost drivers. We heard data from Blue Cross Blue Shield that although these account for only one percent of the prescriptions written, they are 50 percent of the insurer’s pharmacy costs. These new drugs – you see the names like Humira and Enbrel on television ads -- are life changers for people with conditions that may have left them bedridden in the past. The costs, at least in part, are driven by the time and effort manufacturers put into developing them.
However, the whole arena of manufacturer pricing is kept in a black box. This year, we are taking a number of steps to try to push back. Three years ago we unanimously passed a first-in-the-country disclosure law that requires drug manufacturers to share information to justify the increases for the drugs with the biggest price jumps. The results were a bit disappointing because many of the answers were so vague. We plan to strengthen the bill this year.
There is also a bill to ban the “gag orders” that some drug distribution managers place on pharmacists, prohibiting them from telling customers about a lower cost alternative unless the customer directly asks.
The biggest initiative is to develop a Canadian import plan that would be organized by the state itself. Not every drug is less expensive there, but many are significantly cheaper. This would require receiving a federal waiver, but such waivers are directly permitted under the Affordable Care Act. An interesting aspect is that there is another state that is also aggressively pursuing this idea: Utah. Of particular interest, because Utah is one of the most conservative states, and Vermont one of the most liberal. The idea of teaming up on this is appealing!
There is a slightly more convoluted proposal the Senate has sent us regarding expanded bulk purchasing of drugs by the state. Since Vermont Medicaid already does this in a consortium with a number of other states, it isn’t clear what further gains this might bring.
***
Mental Health Care
Just a few weeks ago, my committee said in a memo that it was time for hospitals to step up to the plate and recognize the importance of equity in addressing mental health conditions as a part of health care. Somehow the state keeps being expected to be in charge of providing psychiatric hospital care. Now the University of Vermont Health Network is doing just that – stepping up.
Though the proposal is not at all fleshed out yet, it would be based upon a master plan for future expansion of the Central Vermont Medical Center that would include a new psychiatric inpatient wing. That would add desperately needed capacity for Vermonters who are currently often waiting for days, and sometimes weeks, in emergency rooms waiting for a hospital bed. It would also mean we would more of our statewide psychiatric care into the modern era for the standard of care, which is to be fully integrated with a medical center, since mental health and other medical conditions are so deeply intertwined.
We still need to do more intensive planning for interim capacity, because that plan, if it does gel, will be several years in the making. But it was welcome news to many legislators’ ears.
***
Please stay in touch as you hear about issues affecting you and to keep me informed about your views.You can reach me at adonahue@leg.state.vt.us. Thank you for the honor of representing you.


Saturday, March 24, 2018

March 24, 2018 Legislative Update


We passed a $6.8 billion state budget last week that increased from last year by only 1.1 percent. It shifted a few spending priorities from the governor’s proposals but kept under his limit on growth in spending.
One priority area was the crisis in emergency rooms, where Vermonters are sometimes waiting for weeks for an inpatient psychiatric bed to open up. The governor’s budget added some outreach workers, and I suggested two other measures that were also funded in the House budget. One was expanding the toll-free Vermont Support Line (833-VT TALKS) to 24/7. It has shown huge success in peer support for individuals in crisis who might have otherwise gone to the emergency room because they didn’t know where to turn for help. Indeed, that funding will likely do more to help prevent suicide than any gun bill we pass.
The second was expanding supported housing for homeless individuals being discharged from the hospital. It doesn’t take a rocket scientist to figure out that if someone was at the level of psychiatric crisis to need to be in the hospital, and is discharged to homelessness, they will relapse and be back in the emergency room in short order.
The budget was not completely squeaky clean in terms of the “no new taxes or fees” pledge, though it came close. In separate tax bills, we held back some of the money that was to be returned to Vermonters by a restructuring of state income taxes. (Without the restructuring, the new federal tax law would have resulted in an increased state tax.) Of the $30 million, about $2 million went instead to fund the Social Security tax exemption that had been built into the governor’s budget through other cuts in spending.
We also added a tax on e-cigarettes – similar to the way we tax other nicotine products. If, in the same way as the others, it went into the health care fund, I would have supported it. Instead, it went to help fund added budget items that the governor had paid for through other spending cuts.
The tax bills included the new education funding proposal that shifts $60 million from property taxes to an income tax surcharge. There are pros and cons to the change, but I had a more basic objection. The income tax would be retroactive to this past January 1. The property tax reduction would not be effective until next year’s taxes (July 1.) It may be a simplistic perspective – it didn’t seem to bother most people – but I simply cannot support retroactive taxation. I voted against both tax bills.
All of these measures now go to the Senate, where we can expect changes before final bills go to the governor.
***
A few key environmental initiatives were also addressed recently.
It’s a pretty sad thought that we need to have a “lake in crisis” designation, but our water quality issues are getting that serious. So I supported a bill despite some trepidation over the extent of the delegated enforcement power it gives the Secretary of Natural Resources to act beyond existing regulations if a lake has been deemed to be at that stage of pollution.
I also supported a bill that will establish a “stewardship” program for household hazardous waste, to go into effect in 2021 if a working group does not identify better ways to improve access to safe disposal. A stewardship program puts the cost of disposal up front, as part of the purchase price, instead of charging at the time of disposal. We do it now for batteries, paint, and CFL bulbs. Last November, my siblings and I cleared out my Mom’s house for putting it on the market. We ended up with a batch of hazardous waste, but no access to disposal until this coming May. So it still sits there while the house is being shown to prospective buyers.  It’s easy to see why folks get tempted to hide these items in their regular landfill trash – polluting groundwaters as a result.
The other area I would support a stewardship program is for tires, which could significantly impact that blight on our landscape. The pending bill on tires did not make it out of committee in time for this year.
***
I am loathe to delve into the emotional topic of the gun safety bill debate, simply because there were more complexities to the various proposed restrictions than what can be explained in a brief written update. I’m happy to discuss them in more detail with any individual. I have maintained a consistent position in support of any safety measure that was actually workable and that did not place burdens on law-abiding citizens disproportionate to actual safety benefits.
In brief summary that meant “yes” votes on removal of firearms from persons shown to be at extreme risk of violence (even though they have not committed a crime); temporary removal of firearms from a domestic violence scene; the weapons disposal process for law enforcement; and the ban on “bump stocks” that turn semi-automatic firearms into illegal automatic firing guns.
I voted “no” on requiring individuals to go through a gun shop for sales to friends (so-called “universal background checks”). Individuals already face a 10-year federal prison term for selling to a prohibited person, which is likely why such sales have never been the source of weapons for mass shooters. I also voted against making magazines holding more than 10 rounds illegal (these are standard for shooting competitions and have no date stamps that would enable it to be determined whether someone was in violation or not); and on age discrimination among legal adults for purchase of firearms.
All of these passed in the House. How very much I wish we were not delivering false promises to Vermonters that these measures will actually improve safety.
***
The Vermont legislature has never, in the past, been appropriately compared to the ugly partisanship that occurs in Washington, D.C. How do I define “ugly partisanship”? It is when actions have nothing to do with honest or even passionate political disagreements over policy. It comes when a majority party deliberately uses its control over rules of procedure to block debate or squelch the voice of the minority.
That happened last week in Montpelier.
Our work on the House floor – the presentation of bills by committees so that we can understand what we are voting for, the debate when there are concerns, and the votes themselves – was declared as being merely a “show” by the Democratic minority assistant leader. The context was an unprecedented vote to authorize a policy committee to meet and work on bills at the same time that the floor is in session.
The significance is that members of a committee are forced to choose: participate in hearing witnesses, analyzing pros and cons of a bill, and taking part in the committee’s decision to recommend a bill to the full body versus participating in hearing the presentation of bills on the floor, listening to and participating in debate, and voting.
On an individual basis, members do sometimes make their personal choice to not be on the floor when addressing another priority matter. I have done it myself for brief periods when consensus bills are under review. At times near the end of the session, there are enough members rushing around getting final work done that there needs to be a quorum call on the House floor.
One major embarrassment to the body occurs every time there is a roll call vote on a major bill. A warning bell rings, and legislators who were absent during debate flock to the floor to cast their votes. It means that those members felt they had no need to hear what their colleagues had to say before voting. In another sad commentary on how we address our responsibilities, I have a reputation in the House as someone who “actually reads all the bills.” In other words, that’s a rarity. But all of those are individual decisions by members as they juggle how they meet their obligations. They are accountable to their constituents for how they balance these priorities.
The difference in what occurred last week is that the Judiciary Committee was authorized by a vote of the House to meet as a whole and take formal action on bills while the rest of the body is on the floor. The reason: the chair’s desire to continue moving as rapidly as possible on the gun bills it was considering. We were not without adequate time to address those bills through the normal process, but the effort was being made to rush them, without even the typical public hearing that occurs for controversial new proposals.
Those committee members were thereby forced to choose to miss votes in one setting or the other, or to cast votes in one setting or the other without the information for an educated decision. They were being involuntarily compelled to abdicate their responsibilities either to being present on the floor or present in their committees. There is a reason that House rules say that committee chairs are not permitted to call their committees to meet without the permission of the full body. It is to prevent that conflict. That is why a House vote was required on whether to grant permission to the Judiciary Committee to meet.
The outcome was directly along political party lines, which meant an 82-52 vote that placed minority members in that untenable position, in the interests of the majority to move those bills forward. It was raw political partisanship.
In explaining my “no” vote in a formal statement, I pointed out that our processes are intended to protect the voice of the minority. “That voice has been trampled on today, through an unconscionable and unprecedented vote by this body. The significance cannot be understated.”
The assistant majority leader then provided her explanation: “It has been said the committees do the work of the people; the floor is the show. Enough said.” It was a staggeringly arrogant acknowledgement that majority membership feels its presence on the House floor is unnecessary. Its members can control the outcome of every vote. There is no need to listen to other perspectives.
Although I am a member of the minority party, I would feel the exact same way if the roles were reversed. I believe the outcome was a sad day for Vermonters and their right to be represented in the people’s House.
***
Please stay in touch as you hear about issues affecting you and to keep me informed about your views. You can reach me at adonahue@leg.state.vt.us. Thank you for the honor of representing you.





Friday, March 9, 2018

March 9, 2018 Legislative Update


Legislative Update
Rep. Anne Donahue
March 9, 2018

As we return from the town meeting week break, the most important bill of this year will be coming before us. Other subjects may capture bigger short-term headlines, but it is taxes and expenditures that are the largest responsibility of government. Several things are combining to raise the possibility of significant changes in our tax structures this year.
First, there has finally been some momentum on changing how we fund education. Second, the changes in the federal tax code for next year have a big impact on Vermont, because our state taxes are currently directly tied to the federal formula. If nothing was changed, it would mean a $30 million bump in state income tax revenues: in other words, a $30 million tax increase. Third, under Governor Scott’s leadership, we are finally trying to address the inequity of taxing retirees Social Security benefits. Vermont is one of only six states that fully taxes them.
The House Ways and Means Committee has voted out a bill that addresses these things together, which allows for some trade-offs between the lines. Trade-offs meaning, if we stop taxing the first $40,000 (single) or $60,000 (2-income) of Social Security benefits as per the plan, the money has to come from somewhere else. So although the new proposed structure for the Vermont income tax is intended to keep everything as much the same as possible for individuals, not all the money will be returned.
The new system would mean we will no longer be able to file Vermont returns by just transferring numbers from our federal returns. There would be a state personal exemption, standard deduction and charitable deduction, and a new, lower marginal rate. (Don’t forget: lower rates do not automatically mean lower taxes – a lower rate on more taxable income would mean taxes stay the same.)
The education funding proposal would create a new income tax surcharge that would shift about 10 percent of education revenues away from property taxes. The new surcharge on income would be a rate ranging from 0.1 percent on lowest bracket, 0.5 percent for middle brackets, and one percent on highest income brackets. The estimated reduction in the education property tax rate for Berlin (at its $17,465 per pupil cost) would be from $1.78 to $1.65, and for income sensitivity, from 2.94 percent to 2.74 percent. For Northfield ($14,808 per pupil cost) the property tax rate would drop from $1.45 to $1.26, and the income tax rate from 2.45 to 2.09 percent.
This makes a small change in where the taxes would come from – property versus income – so no one should be fooled into thinking that overall taxes are going down just because property taxes dip. In fact, the big concern I’ve heard is that the change could result in an easing of the property tax pressure, resulting in approval of big increases in school budgets. On the flip side, the mechanism would create a more obvious and direct impact on local towns if they are high-spending, instead of those costs being spread across the state. That could make local communities feel more empowered over local budgets. It’s pretty dispiriting under the current system when a community bites the bullet to keep budgets low, only to see taxes still go up because other towns spend more.
The current bill is a big change from what was being discussed just a few weeks ago, which involved a much bigger shift to the income tax and elimination of “income sensitivity” – because the new income tax would have addressed protection of low income homeowners. The revision also means failure of the goal of making the system easier to understand, since much of the structure will remain the same.
All these proposals have a long way to go before becoming law, because once they pass the House, the bill starts anew in the Senate, which may have its own idea about what changes should be made. Stay tuned – and share your input.
***
Sometimes only the big issues hit the news. For a sense of the backlogs of bills that are on the calendar the day we return (a result of the deadline for bills to be out of House committees if they are to have a chance before the Senate this year), here is just a sampling from the list, from mundane to major.
H. 907 Improving rental housing safety
H. 909 Technical and clarifying changes in transportation-related laws.
H. 910 The Open Meeting Law and the Public Records Act
H. 911 Changes in Vermont’s personal income tax and education financing system
H. 599 Games of chance organized by nonprofit organizations
H. 620 State-owned airports and economic development
H. 707 The prevention of sexual harassment
H. 736 Lead poisoning prevention
H. 766 Creating a homeowner’s rehabilitation tax credit
H. 780 The inspection of amusement rides
H. 802 Rural economic development infrastructure districts
H. 831 Funding for an accelerated weatherization program
H. 854 Promoting television and film production
H. 874 Inmate access to prescription drugs
H. 894 Pensions, retirement, and setting the contribution rates for municipal employees
H. 903 Regenerative farming
Feel free to ask me more if any of these pique your interest.
After this week, the House will begin to focus on what the Senate has sent us, and vice-versa.
***
Examples of routine House bills that came through the week before the break that were passed on mostly unanimous voice votes were:
H. 684 Office of Professional Responsibility. Annual update of professions regulated by OPR. I heard a lot of concerns about discontinuance of licensing to permit persons to do ear acupuncture for substance use treatment. Because the committee took in depth testimony on both sides, I accepted its judgement and voted in support.
H. 711 Crime Victims Protections. Requires unpaid time off for persons who need to testify as crime victims.
H. 728 Bail Reform. Prohibits money bail for misdemeanors. Bail – even low amounts for small crimes – can mean that poor folks sit in jail waiting for trial, which those who can afford it, get out. That’s not exactly justice.
H. 901. Health Information Technology. A bill passed by my committee setting strict standards for the Vermont Information Technology Leaders (a public-private partnership in charge of Vermont’s health information exchange) to get its act together or face defunding next year. VITL has been flying under the radar for years, getting state funds and not showing good results.
H. 378. Creation of an Artificial Intelligence Committee. Do we need to regulate this newly emerging technology? Maybe not – but we better find out.
H. 615. Prohibiting use of drones near correctional facilities. Now, that was a no-brainer!
H. 726. Creating a voluntary pollinator-friendly solar-generator standard. An effort to prevent false claims that a solar site is being managed to provide greater benefits to pollinators and shrub-dependent birds.
H. 614. Sale and use of fireworks. Prohibits use between 10 p.m. and 7 a.m., except for New Year’s and the Fourth of July.
***
The contentious bills of last week:
H. 237. Saliva Testing. A roadside test is now available that shows whether one of seven drugs (including legal ones) are in your system, but without any indication of whether they are at a level that can impair driving. Yet, allowing this test could result in an officer deciding to hold you, or release you, on what is essentially invalid evidence. Even an amendment that required that testing devices meet the same standards as breath testing devices failed. There was extensive debate over two days on this bill. I voted no; it passed easily. I think the legitimate anxiety about increased driving with marijuana-impairment after legalization on July 1 drove this bill forward. It’s a valid concern but a bad way to address it.
H. 675. Conditions of Release. This small, non-controversial bill clarified the right of judges to order defendants to not possess weapons when released pending a trial on criminal charges.  Because any bill can become a “vehicle” for other topics as long as they are germane to the underlying bill, it turned into the most controversial bill since the marijuana debate in January.
The Senate had just passed its “Extreme Risk Protection” bill on a 30-0 vote, creating an avenue for immediate judicial orders to take away a person’s weapons in cases where a crime had not occurred, but there was evidence of significant danger to a person (suicide) or to others (homicide.) The Senate had taken weeks of testimony to strike a balance between safety and defendant rights, but the House Judiciary Committee had just passed a bill based on two days of rushed process that changed that balance, setting a lower standard for taking guns away, and allowing it for a year instead of 60 days.
House Judiciary had added its own domestic violence bill, which had passed the House last year but was sitting in the Senate because it had become unnecessary – the Extreme Risk bill covered those circumstances, and many more. I had voted against the House bill last year because of constitutional problems.
The Senate bill could have gone straight to the governor the Friday before town meeting if it had passed the House. Any changes meant a long delay with conference committees between the two bodies. I tried to get the Senate bill in front of the House through amending H. 675 to incorporate what the Senate had passed. The House leadership then called a two-hour break to propose an amendment that matched the bill that House Judiciary had passed.
Since the Speaker has discretion over which amendment to take up first, she chose the House Judiciary version of the Extreme Risk bill. After extended debate, it passed, 93-46. The domestic violence portion, which had been changed to allow judicial review in one day, passed 112 to 28, with my support, since the due process issue had been corrected. After that, the handwriting was on the wall. My deferred amendment gained some crossover votes from those who had voted for the House version to match the Senate bill, but failed, 85-53.
There will be much more to come on gun safety initiatives in the weeks to come, and many long conference committee hours before we have final House and Senate votes. Unfortunately, most of the remaining proposals are “feel good” reactions that actually address nothing about the true safety issues.
***
Please stay in touch as you hear about issues affecting you and to keep me informed about your views. You can reach me at adonahue@leg.state.vt.us. Thank you for the honor of representing you. My blog of legislative updates can be found at representativeannedonahue.blogspot.com.




Saturday, February 24, 2018

February 24, 2018 Legislative Update

I don’t think anyone can walk away from the events of the past week without recognizing the deeply felt need to respond constructively to the levels of violence in our country – and not just related to schools. 
We need to be coming together as a community to truly consider the many complex issues that contribute, not to just react in narrow ways that are specific to the most recent horrors.
What do I mean by reacting in a narrow way?
The proposal to limit gun sales to those 21 years or older is getting center stage right now because the Florida shooting was by a 19-year-old.
Does it make sense as a broader public policy? It certainly might. But it needs to be considered on its own merits, not based on reaction to a single specific circumstance.
I am committed to listening to the proposals that come before us in the Vermont legislature, and supporting those that offer real solutions.
However, we need to recognize that some proposals only create a false sense of security. I think that many people are very anxious for that perceived security, and mistakenly see every possible restriction as an answer.
We do need to have open conversations that put everything on the table, including looking at whether and where changes in our guns laws can make a difference. One of our obstacles has been the lines drawn in the sand that do not allow for this kind of difficult conversations.
I am equally concerned about pointing to mental health issues, which are frequently an equally misleading path.
I think we immediately try to pathologize unthinkable acts as evidence of mental illness because we can't bear to think such acts could be knowing and deliberate.
The vast majority of people with mental health challenges are not violent, and I fear the "perceived security" issue could lead to denying rights of those folks inappropriately, as well.
Research has shown that the rate of violence is not greater among those with a mental illness compared to those without. The greatest predictor of dangerousness is a history of violence, not a history of mental illness.
I am not a gun owner or a hunter, but I am a person with a history of serious mental illness, so my concern over this response is based on my direct experience.
It sounds so incredibly reasonable to say that we “must keep guns out the hands of the mentally ill.” Who could question that? It is a rallying cry on all sides of the gun issue.
But it begs the question, how do we define, “the mentally ill”? Note that immediately, when we use the term “the mentally ill” we depersonalize such individuals and make them “the other.”
One out of five Americans will experience mental illness at some time in their life. Should we ban gun possession by any and all of them? How do we define “being mentally ill”?
Do we assume no one recovers from a mental illness? (If so, how do they become state legislators?)
Some might suggest that in order to create the widest possible net of safety, anyone being seen for mental health treatment should be included. Mandatory reporting to the federal database by counselors of clients receiving treatment?
Imagine what that would do to the greatest existing obstacle to encouraging people to seek treatment: the stigma and discrimination that exists.
If there is any degree of enhanced risk, it is among those who do not seek treatment – treatment is the last thing we should want to discourage.
Keep in mind that existing law requires that persons who have refused treatment after being determined to have a mental illness that requires hospitalization already must be reported to the federal database.
Vermont does that – as it does for felons and domestic abusers.
To whom would we further extend that net?
Our issues of violence in our society are far more complex than mental illness or gun laws.
I give credit to the governor for the breadth of his statement when he expressed a new willingness to consider gun issues, because that statement went far beyond guns – and beyond mental illness -- to raise such issues as the impact of toxic childhood trauma. 
I wholeheartedly agree that doing nothing because it is a complex problem is not an acceptable response. We address many complex issues by chipping off what we can, when and where we can.
I am only urging that we not jump to what appear to be quick and easy responses solely because they appear to be quick and easy. They rarely are. Our issues stem from far deeper roots.
***
It was ironic that in the midst of these traumatic events and national discussion, the longest debate in the House last week was a bill to ban coyote hunting competitions that were described by one legislator as the “slaughter of sentient beings.”
I don’t pretend to be an expert on the biological and scientific issues regarding control of predator species and what coyotes do or do not do to weaker species, or whether hunting competitions increase necessary participation in predator control versus being conducted “merely for fun” at the expense of wildlife.
I do think that these are issues that belong in the realm of such experts, and not in the hands of lay legislators who might be basing decisions on emotion or public sentiment rather than science.
Some of those who contacted me said the legislature needed to act because the Fish and Wildlife Board was refusing to act. I made inquiry during the debate on the House floor and learned that was not true.
Rather, it was the Board’s belief that current law did not give it the authority to address questions about hunting contests, even though it has authority for all other rules about hunting.
As a result, I introduced an amendment that would have replaced the proposed legislative ban on coyote hunting competitions with legislation that clarified the Board’s authority to review all such contests (not just coyotes.)
That amendment failed and the bill passed. I guess if the next public outcry is about deer hunting competitions or rabbit hunting contests, we will have to take that on legislatively as well. The coyote issue is now in the hands of the Senate.
***
Fees are not technically taxes, because they are levied for specific state services that we deem should be paid for directly by the users of the service.
When they apply to a service that virtually everyone uses, however, that distinction gets fuzzy. The whopping cost to register a car is but one example.
Many fees tend to nickel-and-dime us in very small ways, but they can rapidly add up. As someone who is very concerned about our tax burdens, it was a tough vote last week on increasing the Universal Services Fund that appears on our phone bills.
The current fee is two percent of the core services bill. I checked my phone bill: last month the fee was 48 cents. The proposed increase would add one half of one percent for four years… 12 cents per month on my bill.
The increase is for the Connectivity Fund for getting broadband services throughout the state – a goal that has continued to elude us.
Like when we all pitched in to get electric wires strung in rural areas that were not cost effective for the service providers, we need to do this. I voted to increase the fee.
But it does give rise to worries about much more difficult debates that will occur later this session.
We also absolutely need to address our polluted streams and lakes.
Where will that money come from?
Proposals have included items such as a per parcel fee on land, or increases in the property transfer tax. Would it be more honest to impose it as a direct tax increase borne by everyone?
I did vote in support of a bill last week that will require a permit from the Agency of Natural Resources for development of land parcels beginning at a half acre, down from the current one acre, as of 2022. It was passed on a vote of 125-12.
That means an eventual wider imposition of fees, plus costs of development (ergo, of new homes, for business expansion, and even for local towns, when they pave roads.)
In other words, it is another hidden tax. At least this one is targeted directly at the cost of ensuring that new development does not further add to pollution from runoff.
***
Further money questions over the next several weeks will include whether we should completely reshape how we fund schools by increasing what we pay from income and decreasing what we pay in property taxes, as well as addressing the annual state budget.
Typical of most budgets, the Governor has proposed some new initiatives along with cuts that both offset the new items and keep the budget from rising faster than taxpayer incomes.
Thus far, the target in the House Appropriations Committee has been to maintain the target for preventing any tax increase. It takes advice from the policy committees regarding both cuts and new initiatives.
The very positive proposals in the human services arena for dental intervention for school kids and for home visits for new mothers got the thumbs down in that committee in favor of keeping critical funds for people who have severe needs for attendant care services at home, and for support for individuals with developmental disabilities, along with rejecting other cuts.
In my Health Care Committee, our advice was to support the governor’s proposed small increase for crisis service programs to help abate the ongoing crisis in lack of access to mental health care that has created persistent backlogs – sometimes weeks of waiting – in emergency rooms.
But we recommended rejecting proposed cuts to our critical primary care system which would reduce Medicaid reimbursements, and the proposal to eliminate the small fund for recruitment of more primary care providers to the state.
We also opposed the cut of state support for insurance co-pays for lower income persons who are above the level of eligibility for Medicaid but do not have employer-sponsored health insurance.
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Among the initiatives that have run out of time for consideration: the bill I introduced to reform the property tax inequity for towns with state colleges versus those with private colleges.
The chair of the House Ways and Means Committee has told me that this effort, spearheaded through the work of Chris Bradley, will not be addressed this session, as the committee has its hands full with the education tax bill.
The bill has at least raised attention to the issue. Only a fraction of bills introduced each 2-year session make it through both the House and Senate process to reach the Governor.
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Please stay in touch as you hear about issues affecting you and to keep me informed about your views. You can reach me at adonahue@leg.state.vt.us. Thank you for the honor of representing you.





Saturday, February 10, 2018

February 10, 2018 Legislative Update

Legislative Update
Rep. Anne Donahue
February 10, 2018

As we near the midsession deadline, issues are heating up around the state house with consideration of two major tax initiatives: reshaping how we pay for education, and revising state income tax rules to prevent the federal changes from becoming a big state income tax increase.
The Senate has also voted on a 6-year staged increase to a $15-per-hour minimum wage, so we will need to be addressing that proposal in the House.
In meantime, we had a major split on a policy bill on the floor, when I led objections to part of a new bill on parentage that would allow a court to order that a DNA sample be taken from a person who is not involved in the court case.
The parentage bill is a worthy and important effort to rewrite old laws to address the realities of the current world, including surrogate births (termed “gestational carriers”), but it also includes a fairly radical provision on genetic testing. In lay language: if your brother is the subject of a lawsuit asserting that he is the biological father of a child, but he has taken off, the court could order that you must provide a DNA sample. (Your DNA could theoretically provide evidence of whether the child had enough common DNA traits to establish that your brother was, or was not, the father.)
If that clause was going to be included in the bill at all, I wanted the actual genetic specimen to be destroyed after the parentage case was concluded. The committee that had passed the bill disagreed, saying there hadn’t been enough testimony to know what the current protocols were for preserving or destroying genetic testing specimens, so there could be unintended consequences. But the committee was willing to go forward with whatever unintended consequences might result from allowing your DNA sample to be taken and to exist – against your will – in some unknown location under unknown protocols!
It is virtually unheard of for an amendment to succeed on the House floor if the committee rejects it. This one came close to a major upset, but failed on a 70 to 73 roll call vote. My efforts did result in some improvements in the bill to require a more protective court process, but the DNA samples themselves will not be destroyed. The bill now goes to the Senate for consideration, and I am hoping this issue will be reconsidered.
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Taxes for Education
One thing everyone agrees on: our current property tax system that contributes to paying for schools is far too complex. One only has to look at what often happens in Northfield: the school board holds to a tight budget with small increases, yet the tax rates go up much higher as a result of spending levels in other towns.
And no one has figured out yet how to slow down the increasing per-pupil costs, as we lose student counts yet keep facing budget pressures. The idea of school district consolidations was probably essential for reasons of educational opportunities for students from small districts, but the cost containment results will be fairly small.
The core of the proposal emerging in the House Ways and Means Committee (the committee in charge of taxes) would be a shift to an income tax surcharge for the statewide share of the education fund. The homestead property tax would drop way down, and would reflect the local district’s spending, without any income sensitivity adjustment (the adjustment for income would be covered by the fact that the income tax surcharge would be scaled based on income.)
It would definitely simplify the system. Despite the intent to keep everyone in about the same tax situation that they are in currently, no system change can do that perfectly, so there would be “winners and losers” – individuals who would do better, or worse, than the current structure. The details are not fleshed out enough yet to know who they would be.
But the big question is what the impact would be on spending levels. What it all costs is a bigger issue than how the taxes are collected. Vermont ranks as the top state in New England in state spending as a share of its gross state product (11.7 percent, compared to next-highest Rhode Island at 10.5 percent), primarily driven by K-12 education spending; education spending as a percentage of the budget ranges from 11.2 percent in Massachusetts to 32 percent in Vermont.
There is a fairly prevalent concept that if taxpayers are “insulated” from spending decisions, they are less likely to hold local spending down. If there is little impact on your property tax bill – because it goes into a statewide pool of money – why vote for a lower, local school budget? That operates if you support the assumption that there are many districts where costs could be restrained, but that local school board (supported by the local voters) are choosing to spend excessively.
If the new system meant that local voters kept tighter control, because their vote directly affected their local property tax – which would be set based upon how much was being spent above the statewide level being covered by the statewide income tax -- it might be a big plus.
If it meant that poorer towns tightened their belts more, but wealthier towns felt comfortable with adding extras, there would be a problem with the equal educational opportunities we are expected to be providing. If it meant that everyone was so relieved that their property taxes dropped so much that they felt it was great to be able to add lots more to their local budget … we’d obviously significantly worsen the overall spending problem in the cost of education.
Some of the complexities of the many variables, including the complexities of why costs keep increasing, are the reason the system hasn’t been changed for so long. While there is momentum this year for a change, it won’t be clear for a while yet whether this initiative will move forward and what the final picture will look like.
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State Income Tax
More tax complexities: the big changes in federal income taxes, and what your return will look like next year, will change the impact of some of the automatic features of how our state income tax piggybacks on the federal. For many people, it means that some of their reduced federal taxes will get partially eaten up by increased state taxes.
The best guess right now is that it could result in $30 million more in state revenues. We could expand our state budget, maybe even filling in for some cuts in federal spending, without having to vote on a tax increase. What a great idea!
Oops. No, not such a great idea. No taxation without representation, right? An increase in state spending by $30 million means a $30 million tax increase, even if it is thanks to a change in federal tax law, not ours. If we feel we need or want to increase taxes, that should happen up front, in a transparent debate. So the governor has put forward a proposal for changing state tax codes to – as best as possible – keep everything the same for Vermonters in terms of current state taxes.
But it will be a very tricky process, because the federal tax changes will impact individuals in very different ways. As with changing the property tax structure, no one wants to suddenly cause some individuals to pay a lot more and others, a lot less. Getting an even outcome will be a challenge.
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$15 Minimum Wage
Speaking of trying to balance impacts: the Senate is moving forward with a proposal to increase the state minimum wage from $10.50 to $15 over the next six years.
There are many aspects that make a strong case for this. I do believe that a full week’s labor should pay enough for a person to live reasonably above the poverty level. At $10.50 an hour, a person is making $21,840 a year, which is just slightly above what the federal government deems as poverty for a 3-person family. Any of us can compare to our own income to consider whether we think this is a “livable” wage – I do not think it is.
Vermont has some good reference tables that include all the additional supports that low income persons receive, and where that places them in comparison to what Vermont deems a “basic needs” budget. That scale estimates that it takes about $70,000 in resources for a single parent, 2-child family. Again – that become a subjective conclusion about defining basic needs.
Economic arguments for increasing the minimum wage include a savings in what the state spends in various subsidies for those with low incomes and increases in income tax revenues, as well as more buying power for families, resulting in strengthening the economy.
The basic needs budget graph shows the value of all subsidies – childcare, healthcare, food stamps, tax credits, etc – to show where that sample 3-member family falls. If there are no wages coming in, the benefits total about $43,000. As earned income increases, those total resources go up. At wages of around $22,00, combined with benefits, the family reaches $62,000 in net resources.
Then comes the cliff: if you earn more, the subsidies drop faster than your wages increase, so at the point of reaching $36,000 in wages, total resources have dropped to about $52,000. Getting ahead is penalized. (If the state were to attempt to level that cliff, it would cost $66 million.) It is not until earning a net salary after taxes of $48,000 that the family gets back to net resources of $62,000. After that, the progress towards the $70,000 is a bit more even (there are some smaller cliffs) until actually arriving there via after-tax income alone.
So here’s the irony for that sample family: if the minimum wage went from $10.50 to $15 an hour, the total family resources could go from $62,000 to around $56,000!
The Senate plan would increase the threshold for the child care subsidy to help offset that effect – at a cost between $4 and $12 million -- but that does reduce the arguments that say the increase would reduce state spending on subsidies, since that’s the largest direct state funding on family supports. And while keeping the child care subsidy in place at higher wage levels would prevent the drop-off, the increased minimum wage would still would not increase that family’s spending power.
Our legislature’s non-partisan fiscal consultant projects several thousand jobs being lost from the economy if the increase went through, from businesses that would have to cut back based on the increase in wages. Its report also estimated that increases in state tax revenues and reduced benefit costs would be “a net fiscal gain to the State of approximately $23 million” [not counting an expanded child care subsidy cost] under the proposal, “balanced against a $69 million net reduction in federal dollars in Vermont’s economy.”
So nothing is ever as simple as it sounds.
All this assorted data plus much more detailed analysis is available on the Joint Fiscal web site, www.leg.state.vt.us/jfo/
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Please stay in touch as you hear about issues affecting you and to keep me informed about your views. You can reach me at adonahue@leg.state.vt.us. Thank you for the honor of representing you.



Sunday, January 28, 2018

January 26, 2018 Legislative Update

We don’t get the “fake news” that plagues social media, when it comes to our local news outlets, but that doesn’t mean we don’t get our news twisted up. The word-of-mouth floating around about Governor Scott’s proposal for a privately-run prison and mental health facility that adds 925 new beds is a good example.
Virtually every word in the sentence above is inaccurate, but has shown up in someone’s version in describing the plan. My committee heard the full overview directly last week.
-        There is no proposal for a privately-run facility. The suggestion was that it might be constructed through a private company and then rented to the state to avoid having the state carry the $125 million construction price on its books. But it would be run by the state.
-        There is no plan to add 925 beds to our prison capacity. The facility would replace two existing prisons that are more expensive to run and maintain because they are outdated. It would also bring back the prisoners that we currently send to out-of-state prisons.
-        There is no plan to address mental health needs by creating a new “prison and mental health facility” on the same site. The mental health part of the plan is for providing services to inmates in corrections, not for co-mingling prison and mental health needs.
There are many reasons that I’m not sure the plan makes sense, but if I oppose it, I want it to be for the right reasons!
The pros include the fact that I really believe it is wrong for us to send Vermonters to prison in other states – or if we do, that we should be giving those inmates a shortened sentence. It is not equal justice for one person to be send hundreds of miles away, while the other can maintain connections with local family and support systems.
There is also an urgent need to provide mental health care within corrections. We are required to provide appropriate medical care to the people we hold in prison, and many are not receiving it when it comes to mental health.
The cons include the challenges of recruiting enough staff for a large, consolidated prison in a rural, northwest corner of the state. The mental health plans include a 20-bed forensic hospital, which means recruiting psychiatrists and other medical personnel to serve there, an even more difficult task. This is a healthcare specialty that already has shortages, and the state has been unable to fill staff positions at the psychiatric hospital it runs in Berlin. Staff there frequently are forced to work mandatory overtime shifts, creating dangerous conditions.
I’m also very concerned about the way the whole proposal has blended and mixed up what Vermonters need. The proposal arose from a legislative directive to review the state’s needs in a number of different areas. One high priority for our state is, in fact, mental health care – a whole separate subject from corrections. The two subjects are being tied together in a way that feeds on stigma and discrimination against those who have mental health needs.
There are people with mental illnesses that commit crimes. There are men who commit crimes. The vast majority of people with a mental illness do not commit crimes. The vast majority of men do not commit crimes. Let’s not confuse things just because two categories have an overlap.
Anyone following the news in the past year knows that we have a health system crisis in Vermont, resulting in people spending days, and sometimes weeks, waiting in emergency rooms for a hospital bed, because of a lack of access to mental health care.
There are no direct proposals in the new plan that address that lack of access.
The indirect proposal is the suggestion that because there are some current hospital patients who are also within our criminal justice system – those who overlap the two systems – if we open a hospital wing in a prison it will free up some current hospital beds for people who are waiting in emergency rooms.
It’s a hypothesis that some experts are questioning. Many of those waiting, for example, are children; the plan creates no new space for their needs.
Speaking of children: another part of the mega-prison plan is to potentially also have one building on the campus for juvenile offenders. It’s a back-up plan, if we can’t get federal funding to run a new facility that would replace the current one, Woodside, in Essex. That’s a proposal enough to send chills up the spine of any professionals who address the needs of children.
So legislators will need to see a lot more data before coming to any conclusions about whether this plan moves us any closer to solutions – or to decide upon alternatives.
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Last week we heard the governor’s annual budget address. I’ve heard enough budget addresses by now to know how much they are all the same: full of ideas that sound great, but impossible to judge until we see the actual numbers.
It is certainly vital to protect against increases in taxes and fees that grow faster than the economy – and our paychecks – and I applaud the governor’s commitment to that. His desire to invest in economic growth is also important if we are going to keep our ship afloat.
But every budget is about where and how priorities are juggled: what moves to the front of the line, and what gets pushed back. That’s what will need legislative scrutiny.
It is hard to figure out how the schools’ budget gap will be filled to prevent a major property tax increase. Last year, in the compromise that ended the stalemate between the governor and the legislature over teachers’ health care, rates were artificially lowered by taking money from savings that would have helped out this year. In that way, the legislature could say it kept tax rates down without giving in to the governor on the health insurance plan.
Now, some people seemed surprised that we have a shortfall. It’s going to bite us this year, and every year, if we can’t figure out how to slow down the growth in costs.
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My health care committee held an evening public hearing last week on access to health care, with a particular focus on access to primary care. It was a depressing hearing, since most of the 50 or so citizens who testified are people having real challenges in getting affordable care. Most were pressing for the legislature to go back to work on creating a universal, single (state)-payer health system, or at least to start on that path by creating a universal primary care system.
What people did not seem to realize is that we cannot control a decision like that, unless we want to try to run a system with less than half the money it currently runs on. We live off the federal system and federal money, whether it be through Medicare, Medicaid, or tax benefits. If they don’t give permission, we lose the money.
The so-called “All Payer” model that we are beginning to test in Vermont right now is based on following the structure that the federal system allows for. The federal Medicare system established the “Accountable Care Organization” model that funnels the money to an organization that is in charge of coordinating care with a goal of more efficiency and better outcomes.
Vermont is trying to piggy-back on that, by having the state Medicaid program and private insurance companies use that same organization (“all payers”), hoping for even greater efficiencies and reduced administrative costs, with more time for doctors to care for patients.
Based on the testimony we’ve been hearing in committee, the new approach is still in its infancy, and most Vermonters do not yet have their care being coordinated by “One Care,” the ACO that is in place here. You will know if you are brought under its umbrella through a letter; whether that happens depends on which insurance you have and who your primary care doctor is.
At best, however, all this reorganizing will only make price increases a bit less steep. We still have a health care system that gives great protection to the very poorest, and excellent coverage to those with employers who can afford to offer good benefits. But despite the subsidies for lower income families, health insurance and out-of-pocket costs continue to take a bigger and bigger chunk out of the paychecks of the majority of Vermonters.
When we talk about affordability, it can’t just be about taxes. It has to be about all of our essential needs. We must just keep plugging away at whatever gains we can make.
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Please stay in touch as you hear about issues affecting you and to keep me informed about your views. You can reach me at adonahue@leg.state.vt.us. Thank you for the honor of representing you.