 |
|
|
|
|
|
|
For the Week Ending April 14, 2006 Major milestones were reached in the reform process last week, though; when both of the Senate committees assigned to work on the House-passed reform plan (H.861) completed their work and sent the bill to the full Senate for passage. In an important victory for Senate Democratic leaders, and perhaps a sign that a bill will become law this year, half of the Republican Senators voted for the bill when it came to a final vote on Friday afternoon. The Senate approved all amendments proposed by its Finance Committee and Health and Welfare Committee and then gave its final approval to the amended bill by a 24 to 3 vote. As amended by the Senate, H.861 establishes a statewide chronic care infrastructure, Medicaid initiatives to reduce the cost shift onto private health plans, and a plan to cover the uninsured (Catamount Health). Currently uninsured Vermonters who are Medicaid eligible (about half of the uninsured) would be enrolled in Medicaid. Uninsured Vermonters who are eligible for employer-sponsored plans would be encouraged to join their employer plan through premium subsidies for those whose incomes are less than 300 percent of the federal poverty level. And those uninsured Vermonters who are not eligible for an employer-sponsored plan could enroll in Catamount Health and also receive subsidies based on income. The Senate would finance the plan by increasing the state’s tobacco taxes and by requiring employers who do not offer health benefit plans to pay a per employee annual assessment. If 98 percent of Vermonters are not covered by 2010, the Senate plan would initiate an individual mandate. BCBSVT is working with the legislature to ensure that any bill that might pass is as technically correct as we can make it. The Plan has responded to legislative requests by providing information and analysis on benefit plans. And late last week the Plan successfully proposed an amendment to remove troublesome language from the bill that would have required insurer rate filings to include specific calculations regarding reductions in the cost shift. The Plan argued that savings from a reduction in cost shift should be identified during the hospital budget review process, where the cost shift occurs. Any savings would automatically pass through to premiums if hospital charges are reduced. Long-time observers of the legislative process are divided over the prospects for reform this year. One camp believes that chances are stronger than ever that there will be health care reform this year because it’s in everyone’s interests to do so. Neither the Republican governor nor legislative Democrats will want to go to the voters in November with no progress on health care reform despite two years of effort, they say. And, according to this theory, the scope of the debate was significantly curtailed in this year’s proposals compared to the far-reaching bill the governor vetoed the year before. Both parties could claim success: the governor for keeping reform focused on realistic and achievable goals; the legislature for following through on promises made in the last election. The other camp thinks the philosophical differences between the approach favored by the governor and the bill the legislature is likely to send the governor to sign are too significant to allow for a compromise. Neither the Governor nor legislative leaders are showing all their cards so it is unclear how much of the protesting from each side is due to negotiating strategy or positioning for the end game. For example, early last week Administration Secretary Mike Smith fired off a letter to senators criticizing the Senate proposal and citing two items that “must be in the bill to obtain the Governor’s support.” Those items cited by Smith were a “Massachusetts model” for how health insurance is offered and a financing plan that is sustainable. The administration wants the insurance plan for the state’s uninsured (Catamount Health) to be through existing private health insurance as it is in a recently passed health reform law in Massachusetts, and the administration is concerned that an open ended promise of benefits will commit the state to a financial obligation that is unsustainable. Smith also appeared in person before the Finance Committee to say the bill “will not pass in its current form.” Smith again referred to the administration’s demand that any uninsured benefits be delivered through a private insurance model. The legislative bill would give the state ultimate authority over Catamount Health but would put administration of the plan out for bid to the private sector. The administration favors allowing private insurers to offer Catamount Health-style plans. With both House and Senate passage of H.861, the bill now moves to a conference committee to hammer out the differences between the House and Senate versions of the bill. Although the administration is not a formal participant in the conference committee, they will be an active and critical player in the negotiations. The conference committee process will determine whether there will be a plan that everyone can support and can become law. This week, the Senate will consider a House proposal to amend S.22, a bill to require health insurers to cover off-label use of prescription drugs for treatment of cancer. The House added unrelated provisions to track the chain of custody of prescription drugs to prevent counterfeit drugs. The Senate will also consider House amendments to S.310, the companion bill to H.861 that proposes a variety of strategies to control health care costs, including healthy lifestyle premium discounts, administrative simplification initiatives, and information technology improvements. Both chambers will consider a conference committee report on H.404, a bill that would require insurers to include any willing provider in its mental health provider networks. 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 wish to discontinue receiving these updates or know of anyone else who would like to receive it, please call Kathy Parry or send an e-mail to webmail@bcbsvt.com |
|||
|
|
|
|
|
 |
|
|