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The committee has been working on health care reform all session and had promised a “silhouette” of a plan that they could take on the road for public input this summer and fall. That process expanded as they discussed the specifics of a draft over the past week and a half, and Friday the committee unveiled draft legislation that would create a universal health care plan governed by the State. The committee proposal would create a Public Service Board-type governance structure for state-run health care. A new department of health care administration would coordinate state health care activities, while a regulatory board would approve financial arrangements between the state and health care providers, hear appeals from aggrieved parties and approve certificates of need. A new collection of community health boards would coordinate delivery of care within each region and provide input to the department on matters of concern to the region. The draft calls for financing of primary and preventive care services to be assumed by the new state system on July 1, 2007, followed by hospital and other services on October 1, 2007. The proposal would create a benefits board to identify appropriate health care services that should be covered by the new state benefits plan and rank them in order of priority. Those services and rankings would be delivered to the General Assembly for approval and after approval the price would be based on the average price of current provider reimbursement. The department would then propose a budget for the General Assembly to consider each year. Hospitals would be funded through a global budget. The draft does not identify funding sources but instead creates a committee of legislators to study appropriate broad-based funding mechanisms. That committee would report its recommendations to the legislature by January 15, 2006. The draft also calls for studies of the statewide economic impact of a universal access plan and any administrative savings from a move to single-payer. The draft also would initiate immediate system changes regarding a centralized information system and a strengthened primary care system by expanding federally qualified health care clinics to additional counties. The committee’s proposal drew an immediate negative reaction from Governor James Douglas, who has proposed an incremental plan to reduce the number of uninsured Vermonters. In a statement released late Friday afternoon, Douglas said: “Vermonters want common sense, not politicians and bureaucrats, to govern how they interact with their doctors and hospitals. All Vermonters must have the right to choose the health care plan that works best for them, and not be forced into paying for a single, government run plan, funded by dramatically higher taxes.” The Committee returns this week to put the finishing touches on its draft and hear responses from stakeholders. On other health care issues, an ad hoc legislative committee on Medicaid continues to meet to resolve an $80 million deficit in the benefits program. Legislators hope to address the deficit without raising taxes, and are focused on prescription drug program changes and lower provider payments as solutions. Also this week, the House Human Services Committee begins hearings on two mental health benefits bills. H.404 is an “any willing provider” bill for mental health providers that would prevent health plans from establishing selective networks of providers. The bill would compromise health plan quality and cost control strategies. H.411 would expand the state’s mental health parity laws. Current statute allows health plans to manage mental health benefits on all health benefits plans. The bill would not allow managed mental health benefits in benefits plans that don’t manage physical health treatments. For more information on legislative proposals, visit the Blue Cross and Blue Shield of Vermont website at www.bcbsvt.com or call Leigh Tofferi at (802) 223-6131 or Kathy Parry at (802) 371-3205. If you would prefer to receive these updates by FAX or e-mail, wish to discontinue receiving these updates or know of anyone else who would like to receive it, please call Kathy Parry at the above number or send an e-mail to parryk@bcbsvt.com |
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