Legislative
Update
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 (counterp@tds.net for me; pattijlewis@myfairpoint.net for
Patti) or by leaving a message at the statehouse at 828-2228. We welcome your
feedback and input.
Anne
B. Donahue
