Saturday, February 16, 2019

Legislative Update February 16, 2019


Rep. Anne Donahue

Legislative Update

Feb. 16, 2019



The Appropriations Committees (House and Senate combined) will be holding hearings on this year’s budget proposals. Unfortunately, the “community-based” hearings aren’t very accessible to Northfield and Berlin residents. Presumably that’s because those nearer Montpelier can come in person to the “advocate hearings,” although those are being hosted only by the House.

The joint hearings across the state are scheduled for Monday, Feb. 25 from 6 to 7 p.m. in Morrisville, Rutland, St. Johnsbury, St. Albans, Winooski, and Springfield.

The House hearings in Room 11 at the state house are this Wednesday, Feb. 20 from 1 to 2:30 p.m. regarding budget sections for the Agency of Human Services, and Thursday, Feb. 21, 8:30 to 10 a.m. on all non-AHS sections. Although these are listed as “advocate hearings,” meaning for advocacy group testimony, they are open to any members of the public.

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Budget and Health Care

My committee has the responsibility of making recommendations to the Appropriations Committee on the budget areas related to health care. There are no real “headliners” in these areas this year, but that absence is creating concerns for us.

The governor’s budget proposes no major program cuts, but also does little to help address health care access and affordability or to respond to the crisis in access to mental health care. This crisis has received a great deal of attention because of the resulting burdens on emergency rooms that have patients waiting for days for care, to say nothing of what it does to those patients.

As I discussed in my last update, we are wading our way through many sticky, technical issues affecting the health insurance marketplace: the factors that can impact how quickly rates can rise.

Staff from the governor’s office presented testimony last week on some insurance affordability ideas that could be explored over the next several years, but would have no immediate impact.

There is a really striking graphic that shows how unequal the current cost burdens are. The concept that people should not have to pay more than certain percentages of their income for health insurance falls apart rapidly for those who are just a little bit above the level of eligibility for a subsidy.

The subsidies are also only available to those who do not receive “affordable” employer-sponsored coverage – but strikingly, affordable under that federal definition can actually translate into as much as 15 percent of family income.

Single parents or individuals can end up having to pay a higher percentage of their income than couples if they receive a subsidy, while couples with the same household income pay a vastly higher percentage after they are no longer eligible. At the “cliff” when reaching 400 percent of the poverty level ($66,000 for two people), the very cheapest coverage cost $11,000 for two people, without counting the very high co-pays included in those plans.

We are clearly not achieving equity principles. There are at least two interesting ideas in bills that other members have submitted and I hope we’ll take a look at them. One would require small co-pays from those who get full coverage under Medicaid and transfer the money for more equitable subsidies; the other would look at what we might be able to do by teaming up with a regional multi-state effort.

The one budget proposal that does affect costs is one that could drive them up. Our state regulators of hospital budgets and insurance rates get their budget funded partially through billing those who get regulated (the hospitals and insurance companies) and partially through state funds that are matched with federal funds.

We’ve got a big problem with the goose that lays our golden eggs for health care. (We get a lot more for health care from the feds than we pay in with all our taxes – in other words, other states subsidize us.)

We have a deal with the federal government that allows us flexible use of matching federal Medicaid money for a wide range of investments, as long as it stays under a cap. The cap is based on the federal money we would have been entitled to for regular Medicaid spending if it was not for the creative improvements we make with that flexibility.

We’re almost at the cap. The goose is running out of eggs. We have to prioritize where we spend them.

So the budget for the Green Mountain Care Board (the regulators) proposes to reduce the state and federal funds used, and replace them by billing more to the hospitals and insurers. The problem: our non-profit hospitals and insurance companies don’t actually pay those bills; we do, through higher prices.

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Turning to Mental Health

The Department of Mental Health issued a report to us in mid-January stressing the need for both expansion of psychiatric inpatient beds and for more community services to help prevent people from reaching that level of need.

The University of Vermont Health Network is looking at a 25-bed inpatient expansion at Central Vermont Medical Center. The DMH budget proposes only a 6-bed expansion of supported community residences. That’s a disconnect.

There was a lot of media last week about DMH investing $17 million more into school-based mental health supports to help prevent later, more severe problems. That’s false accounting. That money simply funnels through DMH from local school budgets in order to obtain federal matching funds (part of that “flexibility” deal we have.)

Finally, DMH is proposing to eliminate the funding for supervision in emergency rooms that it started supplying when the ER delays began after Irene.

I firmly believe that all health care costs belong within our health care reimbursement system, including Medicaid, but not funded through separate state money that doesn’t include other insurers. That includes for mental health care.

However, there is one small subset of mental health care that carries a unique cost. For about 10 percent of psychiatric admissions, the state has stepped in and mandated health care that individuals do not request or want: involuntary care based upon “danger to self or others.”

(Sometimes the focus on this small number obscures the fact that most people with a mental health care need want help, just like people with any other health care need.)

Because it is state law that is requiring involuntary care, I think that the costs attributed to forcing people into care – such as staffing to prevent them from leaving the emergency room – is a uniquely state obligation. We should not be transferring this cost to our hospitals.

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Paid Leave, Minimum Wage

Major bills working through House and Senate are those to increase the minimum wage and to create a mandatory paid leave insurance program. Balancing factor questions: will these help attract and retain our workforce and improve financial stability for families? Or will they stall economic growth, increase tax burdens, reduce jobs and hurt the people they intend to help?

Those are the debates on the imminent horizon. I am looking to what those bills will look like when they reach the House floor, any new insights since we debated them a year ago, and constituent input in considering what direction is in the best interest of Vermonters.

Speaking of “what they look like when they reach the House floor,” it is worth noting that 800-plus bills get introduced each year, 100 or so end up being passed, and many are never even taken up. So when you hear in the media that such-and-such has been proposed in the legislature, it is usually premature to either panic or rejoice.

Even when there are reports that a bill has been passed, it usually means it has passed either the House or the Senate – but not yet both. The deadline this year to get through at least one body, in order to even be considered by the other, is March 15. There are always exceptions, but generally speaking the failure to meet this “crossover” deadline means continuation of the bill’s path forward will be delayed at least until next year.

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Word Games

Despite all the weightier subjects before us, much attention this week will be on the debate of H. 57, the abortion bill, which passed the Judiciary Committee on Friday and is expected for debate on the House floor on Wednesday and Thursday.

It’s had a lot of rewording, and the final version makes even more explicit what I described previously. The bill creates no new law (or expansion of legal access) than what has existed before; it also creates no new protection that does not currently exist, regardless of whether Roe v Wade were to be overturned.

Does that include the right to abortion until the moment of at least partial birth? Yes, that’s the current status in Vermont, since we have no limitations in law. Some argue that since such late abortions never actually happen currently, it doesn’t matter that we are passing a law that says there is a right to access them – a somewhat curious perspective on the rationale for passing laws.

Ultimately, it isn’t a bill that changes anything, but it is a bill that forces legislators to endorse the current status, or to oppose it. Since I do not endorse the current status, I will vote no.

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It is truly an honor to represent you. Please contact me with your concerns and thoughts; I’m best reached via email at adonahue@leg.state.vt.us.

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