Representative Anne Donahue
April 16, 2016
Our target closing date for the session is May 6, which means we are finishing our House committee work on bills sent by the Senate in anticipation of several busy weeks in conference committees with the Senate working out differences. Politics will be at its highest levels in these final works, since it will be the last chance for various priorities to make it across the finish line.
Already, the marijuana legalization bill is taking strange courses on its likely path to a conference committee. It’s anyone’s guess what will emerge for final House and Senate votes.
A bill reforming the labor laws regarding independent contractors will likely fall to a political death. It was the product of extensive bipartisan work in the House Commerce Committee. This has long been a tricky area of law, trying to protect workers from being exploited and losing access to employer-paid worker’s comp and unemployment insurance, without being a barrier to individuals who are truly working for themselves. Emerging new technology fields require evolution of old standards, and the committee worked for many weeks to craft a bill that won unanimous support across its political spectrum. It is the most important economic development work of the House this year.
It was derailed from reaching the House floor for a vote in an almost unprecedented way. After the labor lobby objected to changes from current law, some powerful liberal legislators pushed to get the bill sent back to the Commerce Committee for “more work.” There it sits, well past the deadline for crossing over to the Senate and unlikely to be permitted out of committee despite the committee’s own vote to move it forward.
In my Health Care Committee, we are addressing Senate bills that deal with updating managed care and hospital regulation; creating better prescription cost transparency for health plans; blocking vision care plans from limiting the suppliers that optometrists can access; and requiring notice to patients when their provider practice is bought by a hospital. Each has its own labyrinth of detail to unravel, and presents opportunities to add last-minute new proposals. Late session bills are sometimes called “Christmas trees” because so many add-on “decorations” are placed on the underlying bill. The process keeps lobbyists hopping as they try to track issues for their clients.
A piece I tried to add to the hospital regulation bill this past week gives a good snapshot into the role of lobbyists: a role that, at least in Vermont, usually is not the nefarious one that is often assumed.
I’ve long been more than a little annoyed about the way our non-profit hospitals conduct their business behind closed doors. They receive huge amounts of public money as well as the health care resource dollars that we pay in insurance, but develop their policies in private board meeting. More than a decade ago I led a battle to require that meetings be open unless confidential or proprietary information was being discussed. It a political hot potato – hospitals are powerful political players – and the effort failed.
We did get a requirement through back then that hospitals list on their websites the names of board members and the means for “obtaining a schedule of meetings of the hospital's governing body, including times scheduled for public participation.” Unfortunately with a few notable exceptions – the University of Vermont Medical Center as the shining example – most have no times scheduled for any such public participation.
The Senate bill we were working on includes updating some of the information reporting requirements, creating the opportunity for me to propose an new open board meeting clause. It rapidly gained positive traction among some members of my committee.
And panic from the hospital association’s lobbyist.
Unlike a regular bill that provides for lots of advance notice and discussion, this amendment to an existing bill could be on a fast track, and she had concerns on behalf of her client members. She articulated them rapidly: would this create a chilling effect on recruitment for these volunteer board positions? Block open discussion of tricky policy matters? How would “confidential” be defined? What about emergency meetings?
She proposed an alternative. She offered her commitment to work with her members and in particular to discuss with and learn from how UVMMC has been successfully achieving its open meeting process. She would then come back next year with a concrete proposal for how to create a hospital governing process that is more transparent and welcoming of public participation. In exchange, we would agree to hold off on rushing anything into a bill this year, in favor of it receiving full vetting.
My proposed amendment might, or might not, have made it through the committee process, House floor debate, and Senate approval. The hospitals would have been fighting vigorously. Next year, there will be turnover in the legislature, and the issue may well lay dormant.
But I have worked with this lobbyist for many years now, and I know she is a person of her word. We have collaborated on issues of shared concerns, debated vigorously on others, and agreed to disagree on some, and but always with mutual respect. With my agreement to withdraw my proposal, she has protected her clients from a potentially not-well-thought out and disruptive new mandate. However I have gained a commitment for development of an approach that will have a far greater prospect of consensus, and thus, of actually becoming law next year.
The product will be better. The public will be better served. The process will have worked, through the help of a lobbyist during her job.
My committee is also continuing its work on trying to craft a bill that will force disclosures from pharmaceutical manufacturers about how they create – and justify – cost structures and cost increases. The concept is simple. Drug companies defend high prices based on the costs of developing and testing new drugs. We want to say, “Prove it. Put up or shut up. Show us the money trail.”
Some drugs that have been on the market for years suddenly spike in price. Why? We can’t try to protect consumers and build cost containment without knowing what actually drives the costs. There are efforts in multiple states to try to push for this information, and it is likely that these very profitable businesses will fight back with lawsuits.
We have long passed the deadline to get this bill to the Senate. It thus has little chance of actually passing this year. It would remain as only an expression of intent of the Vermont House. But I think it’s a conversation worth trying to force, and a public challenge to pharmaceutical companies worth making. It’s a battle that needs to be fought one step at a time.
Thanks for the honor of representing you! You can contact me or Rep. Patti Lewis by email (email@example.com for me; firstname.lastname@example.org for Patti) or by leaving a message at the statehouse at 828-2228. We welcome your feedback and input.
Anne B. Donahue