The 2025 Session
Rep. Anne Donahue
Dec. 18, 2024
Hello, all, and best wishes for the holidays you celebrate
and for the new year ahead.
Before the start of each session, the Times Argus asks
legislators to share what they see as the priorities and challenges, as well as
their approaches to bipartisanship work, what constituent concerns are, and
“what will be a win” for the session.
These are the answers I submitted:
Priorities
Just to upend the headliner conversation: addressing property
tax increases should not be our highest priority. Framed that way, it is a
deceptive goal that would allow for a narrow solution and fail to address any
real problem – in fact, could make it worse. That is because property taxes can
be reduced by simply shifting education costs into a different revenue source,
like income tax. Those taxes, instead, could shoot up. Lack of affordability is
then unchanged; it only shuffles the deck.
The real problem goes to the entire failed funding system
and, at its heart, to the ever-increasing costs of education and the need to find
out the multiple reasons, and which can be addressed. We have a confluence of
deeply intertwined crises of affordability and access in education, housing,
workforce and health care. One of the biggest underlying drivers – and least
able to be changed by local school boards – is the cost of health care.
Our health experts say a primary necessary intervention for
that is to enhance housing access. Lack of housing impacts people’s health and
impairs workforce recruitment; workforce costs then drive both health and
education costs; but investments in taxpayer-supported housing hit back on
affordability, driving away potential new workforce.
Health care costs and access are a greater crisis with a far
worse current trajectory than education. Yet, if connected to education
spending, the impact there is clear. To use simple sample numbers, if 90% of
your budget is personnel and 20% of personnel costs are health insurance and
health insurance costs go up 15% a year… you’ve got a budget problem that
squeezes out any other needs. That hits school budgets, but also municipal
budgets, business expenses, and health care costs themselves.
Here are the dire facts:
Community hospitals have a steady decline in days of cash on
hand over the past 10 years, going below recommended sustainability. Community
health centers are starting to operate at losses – clearly not sustainable. A
November national hospital finance report projects 705 hospitals at risk of
closing, eight of them in Vermont. Four in Vermont are deemed at risk of
closing in the next 2-3 years.
But for payers… a plan with an out-of-pocket maximum going
to $18,000 for a family of four costs $38,000 per year. Yet insurers are also
at increasing financial risk with their required margins dropping. The average payments
for care made by Blue Cross Blue Shield per person went from a rate of $6,300
per year in January of 2020 to $10,080 in June of 2024. Those comparison
numbers do not include the year of the COVID drop and do not include the
additional consumers payments in out-of-pocket costs in copays and deductibles.
At the same time, consumers are facing longer and longer
waits for access to care. The choice to close the CVMC inpatient psychiatric
unit will drive new ER waiting room crises and deny the highest level of
necessary care, right at a time that needs are increasing. It was a short-sighted,
discriminatory and political reaction to being required to cut costs.
But some types of changes in how services are delivered will
be necessary in the near future.
The reasons that set Vermont apart, with costs higher and
rising faster than elsewhere in the country, is our demographics. Our working
age population is shrinking and our age 65+ population is growing. That means
less in premium revenues coming in, and significant increases in services being
utilized. Older folks need a lot more health care. We’ve known this demographic
trajectory for years, and failed to plan for it, spending money on new programs
instead. Now we have to come to grips with it.
It means looking at more specialty services being
regionalized, and inefficient ones being cut – steps Gifford Hospital recently
started moving on. We also have to stop forcing commercial payers to subsidize
government health programs.
Thus, my highest priority is new health reform actions,
integrated into the entire cross-sectionality of our economic and demographic
drivers.
The Biggest Challenge
Right now, our economy is strong, although facing some
uncertainties over the next several years. However, our revenues are growing
more slowly than the spending pressures. Our budgets have increased above the
rate of inflation for years. For valuable detail on the economic and budget
picture, you can see our fiscal experts’ projections at: ljfo.vermont.gov/assets/Publications/All-Legislative-Briefing-December-4-2024/December-2024-Legislative-Economic-Review.pdf,
and ljfo.vermont.gov/assets/Publications/All-Legislative-Briefing-December-4-2024/JFO-Posting.pdf
The bottom line is that we cannot keep trying to get
everything we want and yet also curb the growth of cost burdens. The challenge
in facing these crises this year will be whether a non-partisan majority will
be willing to make unpopular choices for the long-term benefit of Vermont. Most
of us are willing to say, “yes, cut excess spending… except, not that.” And we
all have a different, “not that.” We need to focus on what the smart choices
are, not necessarily the popular ones, and that will be the biggest challenge.
The other challenge will be the amount of turnover, which
will slow the start of the session, plus the decision of Democrats to
consolidate leadership in Chittenden County. Fully one third of the House will
be turning over, with 51 freshmen out of 150 members. Democratic
representatives, who still hold the chamber majority, elected two members from
Essex Junction as their Majority Leader and Assistant Majority Leader and nominated
the current Speaker, Jill Krowinski of Burlington for election as Speaker in January.
The Senate Democrats have also placed leadership into Chittenden County
members. This presents challenges for the interests of all Vermonters outside
of Chittenden County, where needs and economies differ.
Bipartisanship
I became an Independent this year in the effort to shed some
of the increasing divisiveness that has crept into our statehouse in more
recent years. Labels seem to matter more that our common priorities.
We have the opportunity at a fresh start because voters
rejected having a supermajority of one party. The supermajority created an
attitude of not needing to listen to anyone else’s ideas.
My hope is that we will embrace that change by electing an
Independent Speaker, challenger Laura Sibilia, rather than reinstating past
Speaker Krowinski, who remains grounded in the attitudes of a supermajority.
If we are all committed to best outcomes for Vermonters, we
will be willing to listen openly to all ideas before coming to agreements – or
even agreeing to disagree – in the end results. I am committed to continuing to
do that. Most of all, my mantra should be – though I hate to quote from
Facebook posts, I just saw this one and think it is right on – “Be teachable.
You don’t know everything and you’re not always right.”
Constituent Concerns
Across the board, the major concern I hear from constituents
is about affordability, and not restricted to property taxes. It includes areas
such as fees, housing costs, and the potential of heating cost increases in
order to make Vermont a leader on carbon emissions. I hear a lot of consensus
on doing our part to address climate change, but not to think we can change a
world trajectory by taking on more than our share of that burden.
What Will Be a Win?
It would be a win if we leave without creating a single new
study that simply kicks “solutions” to our urgent and crippling problems to
another year. I want to see us do the hard work of making very specific
progress on health care and education spending, revenue, and quality outcomes.
No comments:
Post a Comment