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LEGISLATIVE REPORT
For the Week Ending March 24, 2006
Vermont Senate leaders unveiled their ideas for a health care reform plan this week as the Senate began its consideration of H.861, a health care reform proposal passed by the House two weeks ago.
The Senate proposal was described at a Tuesday joint hearing of the Finance and Health and Welfare Committees whose responsibility it will be to write the Senate bill. The two committees will work on the proposal separately, with Health and Welfare focusing primarily on the delivery system and care management sections of a bill while Finance will concentrate on insurance and financing provisions.
The key changes the Senate proposes to make to H.861 and described Tuesday include:
| | | | | | | • | Expanding the Catamount health program passed by the House. The Senate version would incorporate an employer sponsored insurance provision similar to that proposed by Governor Douglas. The Senate would allow premium assistance for currently uninsured individuals with incomes under 350% of the federal poverty level (FPL) to join employer-sponsored plans if the employer benefit plan was equal to the Catamount coverage and includes chronic care management
| | | • | Allowing all small businesses to purchase the Catamount plan in a separately rated pool in the state program
| | | • | An individual mandate that all Vermonters show proof of coverage by 2010, and provide subsidies for those who fall below 350% of FPL
| | | • | A per employee assessment (estimated to fall between $200 and $300) on employers who do not offer coverage. The Senate may include a sliding scale based on a yet-to-be-determined factor to mitigate the assessment for the state’s smallest employers.
| | | • | Institutionalizing the cost shift from the uninsured to finance the plan. Hospitals would not be allowed to bill the Catamount plan for in-patient or out-patient care delivered to members enrolled in the new state plan. This provision is intended to “capture” the uncompensated care that is currently in the system due to the uninsured.
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Hospitals and insurers are alarmed at the prospect of the cost shift being made permanent and insurers believe the employer buy-in provision would quickly decimate the private insurance market. Catamount premiums would be based on a provider reimbursement rate set at Medicare plus 10. A reimbursement amount below the actual cost and significantly lower than what private payers pay hospitals now would give a market price advantage to the state program. This provision also would increase the cost shift to employers remaining in the private pool at the same time that pool is decreasing due to migration to the public pool.
In other State House action last week, the House Health Care Committee continues to work on the Senate-passed “common sense initiatives” bill (S.310) and is also drafting amendments to a bill (S.22) to require health plans to pay for off-label prescription drugs for cancer care. The committee hopes to approve S.22 this week. The Senate amended and passed S.285, a bill to require health plans to extend coverage for as long as 24 months to students on medical leave from college. S.285 also creates a study to determine if coverage should also be extended to divorced spouses.
The Senate Finance and Health & Welfare Committees have scheduled their time this week to concentrate on health care reform. The House Health Care Committee will focus on the consensus bill, off label drugs and other issues.
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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