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For the Week Ending April 28, 2006 House and Senate conferees met several times last week to reconcile minor differences in their respective versions of H.861. However, the most important differences continue to be discussed behind closed doors between the House, Senate and the administration. (Another conference committee is meeting on S.310, a separate health care reform bill consisting of non-controversial initiatives such as administrative simplification, information technology enhancements and healthy lifestyle premium discounts.) Governor James Douglas has threatened to veto H.861 unless the proposed uninsured program is offered through the private insurance market, while the legislature insists that private involvement should be limited to contracts to administer a state run program. The administration says it wants to avoid an unlimited new entitlement program that will add to vexing financial difficulties already facing the state’s Medicaid program. The administration also wants to prevent another step on the path toward the Democratically-controlled legislature’s plan for a completely state run health care system. The legislature wants to preserve complete state control over any new program to preserve its goal of a state run health care system. These fundamentally different visions for the future make a compromise very difficult to achieve. Douglas released details of his revised proposal early last week. His proposal calls for two “Catamount Health” – the proposed uninsured benefits program – plans to be offered through private health insurance companies under the supervision and direction of BISHCA. Plan A would be a $500 deductible plan similar to ones now offered by BCBSVT and MVP, and Plan B would be an HSA type plan. Uninsured individuals would be offered a defined public subsidy amount that would be determined annually. A mandatory enrollment and budget cap would ensure that expenditures do not exceed appropriations. Uninsured individuals who are employed by a business that offers coverage would be eligible for the subsidy. The legislative conferees have offered a “compromise” that would allow private insurers to bid on a risk contract, but the compromise plan would have the state determine all aspects of Catamount Health - including benefits and premiums – not a viable prospect for private bidders nor a real compromise in the eyes of the governor. A third option surfaced late last week that would address the administration’s concern and attract participation of the private market. The legislature’s health care reform consultant, Dr. Kenneth Thorpe, proposed that the uninsured program be run similarly to the existing federal employee health benefit plan (FEBHP), where private insurers qualify benefit plans and market them to federal employees. Legislators did not jump at that proposal and it remains to be seen if Thorpe’s plan is incorporated in any agreement. In other activity, the House gave preliminary approval to a bill (S.285) to establish guidelines regarding coverage of disabled adult children and college students on medical leave. The bill also would establish a study of continued coverage for divorced spouses and their dependents. 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 |
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