January 29, 2021 Legislative Update

The “corona-coaster” with its steep ups and downs took on new meaning this past week in the state’s budget. Less than a year ago, we were all terrified about the financial impact of lost revenues. Six months ago, the projections were dire. Now, it seems that we’re rolling in money, thanks to our out-sized benefits from federal relief funds, which have proved to have real economic stimulus value. It doesn’t mean we are not still in deep economic crisis, with families under major stress and businesses hanging on by the skin of their teeth. It does mean we have some resources to shore up supports.

In the governor’s budget address, he stressed the need for the excess revenues – which will be very short-term – to be invested in one-time projects that put us in better shape for the future. It is wise advice, and it seems that the legislature is mostly on board (though not necessarily agreeing on which one-time projects those should be.)

If money is put into new initiatives in the base budget, when we are back on a normal economic course and the bonus money dries up, we will be facing the prospect of eliminating programs. No matter how new an initiative is, that never goes over well. Cutting back is politically challenging.

A one-time project doesn’t add to the base and can help reduce future costs. A good example is increasing investments in broadband, which is generally recognized as a key to long term economic growth and attracting new residents in younger demographics. That means the governor’s budget actually is level-funding many areas in state government while at the same time, making $210 million in one-time funding for economic recovery through investments in housing, infrastructure, broadband buildout, environmental stewardship, carbon reducing initiatives, and government modernization, among others.

There is too much to even describe in outline form in this update, but if you want a more detailed overview (with some helpful graphs included), you can see it by going to finance.vermont.gov/budget/budget-recommendations/operating-budget/fy2022 and choosing “Executive Budget Summary;” as a mere “summary” it is 41 pages long.

It is a definite concern in my Health Care Committee that nothing was referenced regarding health care funding or initiatives, not even in access to mental health supports, which we recognize will face new pressures as a result of the stress created by COVID-19. We will be reviewing our sections in detail for recommendations to the Appropriations Committee.

The biggest budget pressure point is the underfunding of our pension obligations. The state treasurer has made some suggested alterations that the legislature will have to assess. The pension funds are at a critical juncture. According to Treasurer Pearce, no action is not an option. As an example, the unfunded liability of the teachers’ retirement plan has increased from $711 million to $1.9 billion in the past 10 years. This is with the legislature devoting ever increasing general fund dollars out of the state budget to it each year, growing from $42 million in 2010 to $136 million in the current year. The state’s share is expected to go up by another $60 million to $196 million next year. These types of increases are not sustainable, with or without more tax increases. And failure to address it could jeopardize the solvency of the pension funds. That is not an option at all.

All of these decisions will play out on the House side in the next several weeks. The budget will then go to the Senate (they will, in our House opinion, gum all our work up!), then on to conference work to align the two, and to the governor. The good news is that the House Appropriations Committee is trying to expedite its review schedule, which would be in keeping with an aim to keep this session shorter than average and focused on the essentials. The session end is directly tied to completion of the budget.

This year, like last, there will be a separate bill that allocates the new round of federal relief funding. It is more targeted this time, so we will have fewer decisions to make – unless and until something happens down in Washington regarding further stimulus money.

About a decade ago, the legislature added language into statute regarding budget development and the purposes of the state budget. This is what it says:

“The State budget, consistent with Chapter I, Article 7 of Vermont's Constitution, should "be instituted for the common benefit, protection, and security of the people, nation, or community .. ." The State budget should be designed to address the needs of the people of Vermont in a way that advances human dignity and equity and in a manner that supports the population-level outcomes set forth in 3 V.S.A. § 2311.

“Spending and revenue policies will seek to promote economic well-being among the people of Vermont, and foster a vibrant economy. Integral to achieving the purpose of the State budget is continuous evaluation of the use of public funds by systems of outcome measurement based on indicators that measure success in accomplishing the purposes of the State budget.

“Spending and revenue policies will reflect the public policy goals established in State law and recognize every person's need for health, housing, dignified work, education, food, social security, and a healthy environment.

“As consistent with State law and in conjunction with the federal government, the budget will reflect support for economic development, public safety, transportation, and other infrastructure needs.

“Revenue measures shall also be based on the principles of sustainability and stability. The Administration shall develop budget and revenue proposals as part of a transparent and accountable process with direct and meaningful participation from Vermont residents.”

 Lofty goals, but worth putting in writing to try to keep at front and center of decision-making. How does accountability play out? While you can contact me or Rep. Goslant to share your opinion, you also do have a voice beyond our representational democracy. The opportunity to directly state your values and priorities is coming up next Monday in video-conference public hearings on the budget in front of the House and Senate Appropriations Committees jointly.

The two public hearings are on February 8, from 1 to 2:30 p.m. and from 6 to 7:30 p.m. via videoconference. You can sign up to testify using this online form: legislature.vermont.gov/links/public-hearing-fy22-budget, no later than this Friday, February 5. Instructions on how to access and participate in the hearing will be sent once you have signed up for the hearing. There will be time limit based on the volume of participants, likely in the range of 2–3 minutes. The public hearings will be available to watch live on YouTube at the following link: legislature.vermont.gov/committee/streaming/vermont-joint-fiscal, or on Onion River Community Access (ORCA) if you have access to it. For more information you can contact Theresa Utton-Jerman at tutton@leg.state.vt.us or Chrissy Gilhuly at cgilhuly@leg.state.vt.us or call 828-2295. Written testimony can be submitted electronically to Theresa or Chrissy through e-mail.

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Other Notes

My Health Care Committee is currently taking up a somewhat discrete topic related to tele-health, on the specific subject of “audio-only telehealth” (translation: by phone.)

During the pandemic, insurers are paying for telehealth visits, including audio-only, as though they were in-person visits. This is under an emergency rule by state regulators for insurance plans regulated by the state, and voluntarily by other plans. (The majority of employment-based plans in Vermont are not permitted to be regulated by the state.) This has been a critical support during a time when it may not be a good idea to travel to the doctor’s office, recognizing that there are still many Vermonters who don’t have adequate internet for standard telehealth.

Insurers and providers agree that once the pandemic is over, audio-only visits will still have a place in the range of appropriate, quality health care options. Where they don’t agree is whether insurance should reimburse claims at the same rate.

Initially left out of this discussion were patients themselves, and I pushed to hear from that perspective as we finish testimony this week. The assumption has been that since this increases access (less time away from work, avoid travel obstacles, etc), health consumers will all support it.

But the question is one of cost. If you have a high co-pay, or a high deductible plan, “paying the same” isn’t a question of payment by your insurance. It’s out of your pocket. If you are choosing an audio visit, do you think there is equal value – or at least, equal trade-offs – such that it is reasonable that it cost the same as a doctor’s visit? Will you feel comfortable with insisting on an in-person visit if your provider is encouraging a phone visit?

I’d be interested in hearing your views.

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  It is an honor to represent you. Please contact me (adonahue@leg.state.vt.us) or Ken (kgoslant@leg.state.vt.us) anytime to share your input, ask questions, or raise concerns.

January 16 2021 Legislative Update

 Legislative Update

Rep. Anne Donahue

January 16, 2021

As we start a new session staying fully on remote platforms, the extent to which good legislative process is impaired becomes even clearer. 

Last year, the sudden shift to “Zoom” meetings came after a year-and-a-half of working together in committees and on the House floor. Now, we begin a new session with new legislators who have no opportunity to first build those working relationships. 

Vermont benefits from healthy turnover in our House of Representatives, with a blend of the new ideas and energy brought by newcomers together with some “institutional knowledge” from longer-term folks like myself who can help prevent wheels from being re-invented every two years.

The newbies, however, do have a learning curve. There is a need to understand the process itself, how committees function, how bills make their way through the system. Then there is grappling with the complexities of the subject matter itself addressed by each committee.

Just ask our district’s other rep, Ken Goslant, who is so pleased to have been reappointed to the Judiciary Committee. He will be able to really dig in this year, after having gotten that first session under the belt.

I have been re-appointed as Vice-Chair of the Health Care Committee, and we are fortunate to also have the same two other members on our committee leadership team. However, of the eight rank-and-file members, five are new to the committee and four of those are first-year legislators.

The orientation process to our tangled and multi-layered health care system has barely begun, and our plate is already full with issues that demand immediate attention: updating and revising the laws we passed in response to COVID-19 last year, and responding to the midyear budget adjustment proposals (with next year’s budget just around the corner.)

Under the Zoom constraints, we’re operating with roughly half of the time in committee we would formerly have had.

And we’re already half way through January! Yikes.

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COVID Responses

Our committee met jointly with the Human Services and Senate Health and Welfare Committees to get updates on the state’s response to the pandemic, the vaccine rollout, and the expenditure of federal emergency funds; next week we’ll hear about the new federal legislation and what opportunities it will offer the state.

We had a presentation Friday to review the bills we passed last biennium, and it was a reminder of how many pieces need follow up. The crisis in our shrinking health care workforce is a huge one.

At the same time, both House and Senate acted quickly on one new response: a bill allowing towns some alternatives for this year’s town meetings in order to maintain safety.

Our local select boards will have the option of postponing town meeting for several months or moving all issues to an Australian ballot that is mailed to every voter (as was done for November’s general election.) Funding for the mail-in option will be provided through the federal relief funds.

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Bill Explosion

The start of a session is when there are often news media sound bites about all sorts of new “legislative initiatives” that catch the eye. Be careful not to read too much into them – or you can ask Ken or me for specifics.

The reality is that hundreds of bills are introduced at the start of each session, reflecting the individual ideas of 150 House members and 30 Senators. The vast majority will not even be taken up by the committee they are sent to, let alone make their way through the long path to the governor’s desk.

Ten have been introduced in Health Care in the first week. Last year, the session’s total was 66. Of that, our committee passed 12, but only six of those came from individual legislators rather than through our internal committee work.

Although chairs hold the decision-making authority, most take input from the full committee about priorities, and that winnows out many of the proposals. But time often is just as much a limiting factor as lack of interest, along with the “must do” work outside of bills.

One thing is likely for any efforts by our committee in addressing large scale health care reform issues – access and affordability -- this year: there won’t be the ability to take any actions. Federal law (and to an even greater extent, federal money) heavily controls our options.

In the past four years, we had a dual focus. We were monitoring the “all payer” deal with the feds that allowed us to make payment system reforms that could be aligned between Medicare, Medicaid and private insurance; that 5-year deal was one of the few mechanisms available for reform under existing federal parameters.

We also spent a lot of effort protecting the stability of Vermont’s insurance market from changes being made at the federal level.

While it is highly likely that there will be major changes in federal law under a new administration, those will not be happening in the next three months’ time. We won’t have any ability to adapt or take advantage of changes, because we won’t know the new directions, yet.

One of the biggest variables is whether a federal law is written to control what happens, superseding state law, or creates options that allow states to establish their own initiatives. 

The classic example is “ERISA,” a longstanding federal law that bars states from regulating insurance that large companies create for their own employees. Whenever Vermont creates insurance coverage requirements, they actually only affect a limited number of insurance plans.

So, we will likely be on hold this year. There is no point in investing time and energy in restructuring health care if the work will be upended in six months.

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My Bills

Notwithstanding the above comments, we legislators do keep introducing bills in the hopes that they will gain committee attention, if not this year, then the next. 

My list this year includes three bills that continue the efforts at parity and integration of mental health into health care, and one for creation of a working group for recommendation on much-needed reforms to our laws on addressing criminal justice system interrelationships with mental illness; 

Also, along with Rep. Goslant, a bill requested by the National Guard to match federal law in protecting employment rights, and the repeat bill on the effort to have military retirement pay exempted from income tax;

Whistleblower protection for law enforcement officers (to protect against retaliation when they do as we have directed them, and report wrongdoing by colleagues); removing the sales tax exemption from candy (I don’t believe in candy as being “food,” whereas food is an essential that should be exempt);

Can you believe that some car rental contracts in Vermont ban you from using them on dirt roads? It’s buried deep in the contract, and I think consumer deserve prominent notice!

I’m also the sponsor on a bill request from the American Kidney Association to extend medical leave and insurance to cover organ donors – an example of a bill that a committee wanted to support last year, but time was the barrier.

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Access to Your Government

The upside to our Zoom world is your new level of access to seeing what we are doing. Every committee meeting is aired live on YouTube, but also archived. Just go to the legislative web site to look up bills, floor sessions, committee agendas, and committee meetings: legislature.vermont.gov, and feel free to ask Ken or me to guide you on finding what you are looking for.

There is also a wealth of information from presentations made to committees and developed by our staff, in particular both the overviews and “deep dives” by our legislative joint fiscal office (ljfo.vermont.gov), everything from revenue updates to how much a bill will cost the state.

Just meandering through that web site is an eye-popping number of “issue briefs” and topics that may rapidly suck you in... but in a more intelligent way that the way we sometimes get sucked into Facebook posts!

Some immediate examples of resources you might want to look at: the “health care 101” presentation that we are working through as our health care committee orientation (the second topic found under: ljfo.vermont.gov/subjects/healthcare/other-health-care-issues-and-information); the COVID-19 vaccine response plan presentation (legislature.vermont.gov/committee/document/2022/15/Date/1-13-2021#documents-section); and the 2021 presentation to us on “Principles of a High Quality Tax System” (found under the tab: ljfo.vermont.gov/subjects/revenue-and-tax/friday-tax-workshops-2019-session). 

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And Then Other Stuff

As legislators, we also spend time outside the statehouse connecting with constituents and interest groups to help identify needs – such as touching base with the Northfield Select Board last week.

Ken and I also met last week to hear from the Northfield Savings Bank about some of the impacts of COVID. That presentation included an important information tidbit to pass along:

Were you expecting an automatic bank transfer of the $600/$1200 economic stimulus money but have not seen it posted to your account yet? There is an IRS glitch that occurred that relates to people who had accounts through their tax preparers which are now closed. 

If you might be in that category, you (or anyone) can check on the status of your payment directly through the IRS website.

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It is an honor to represent you. Please contact me (adonahue@leg.state.vt.us) or Ken (kgoslant@leg.state.vt.us) anytime to share your input, ask questions, or raise concerns.