Key legislative initiatives are poised for their first major test of the session this week as both the House and Senate prepare to pass and move their priority bills across the hall to the other chamber for further consideration.

Proposals on education cost containment, next steps in health care reform, energy, and a budget for FY 2008 state spending will be debated beginning this week. Already, there are indications of tough sledding for some of those proposals. Debate on education cost containment began last week in the House but was quickly postponed to this week when it became clear that there were not enough votes for approval. And the Senate decided at the last minute not to include a funding source for their energy efficiency initiative in hopes of finding a politically acceptable source of funding when the bill returns from the House at the end of the session. A surcharge on home heating fuel had been considered but dropped in the face of immediate and strong opposition.

A Senate prescription drug initiative was postponed until this week because President Pro Temp Peter Shumlin (D-Windham District), a key supporter, was out of town.

Meanwhile, health care discussions moved ahead quietly. Here is an update on those activities:

Prescription Drugs: The full Senate this week will consider a bill (S.115) containing provisions regulating pharmacy benefit managers, manufacturer marketing and promotion, and other related issues. Both the Finance and Health and Welfare Committees have proposed amendments for consideration.

Health Care Reform: A deal was in the works late last week for additional exemptions to an employer assessment enacted last year to fund Catamount Health. A bill (H.229) making a number of “technical corrections” to last year’s health care reform law was drafted and approved by the Health Care Committee earlier this year, but the legislation stalled in the Ways and Means Committee over a controversial proposal to exempt insured part-time employees from the assessment. The Health Care Committee had already agreed to an exemption for seasonal workers. The “deal” would adopt both exemptions but leave it to Governor Douglas to cover the $800,000 shortfall within existing appropriations.

A “next steps” health care reform bill (H.531) that was approved last week by the Health Care Committee and referred to the Appropriations Committee could be before the full House as early as Thursday of this week.

Naturopath Mandate: A bill (S.39) designating naturopaths as primary care physicians and mandating health insurer reimbursement was amended by the Senate Health and Welfare Committee to include mandatory coverage for PSA prostate screenings and passed by the Senate last week. The House Health Care Committee has tentatively scheduled hearings for the bill during the week of April 17.

Mental Health and Substance Abuse “Parity:” The Senate Health and Welfare Committee held an initial hearing Thursday on a bill (S.114) to expand the state’s parity law to include all aspects of payment, administration, clinical protocols, and provider reimbursement. The bill also would require similar loss ratios for health plans and their MHSA benefit administrators with a goal to prohibit insurers from subcontracting MHSA administration. The House Human Services Committee has an identical House version of the bill and also may hold hearings with the intent to move the bill this year.    

This week, the House will be occupied in full sessions leaving committees with little time for work. The House Health Care Committee will spend its limited time on prescription drug issues related to S.115. The Senate Health and Welfare Committee will use its limited committee time this week on issues related to the Catamount Health (H.229) and next steps (H.531) reform bills coming to them from the House.

New Bills of Interest:

S.205 Introduced by Senator Cummings of Washington District

This bill proposes several initiatives to improve the individual insurance market, including: (1) elimination of the 15 percent cap on annual premium rate increases for safety net products; (2) elimination of safety net coverage, either immediately or through a three-year phase-down governed by BISHCA; (3) elimination of the 20 percent cap on annual premium rate increases for non-group products; (4) moving sole proprietors from the small group market to the non-group market; (5) allowing BCBSVT and HMOs to use risk classifications to charge rates for non-group products that vary from the community rate by up to 20 percent; (6) limiting enrollment in non-group plans to an open enrollment period in November and December or within 30 to 60 days following loss of insurance under specified circumstances; and (7) imposing a mandate for all individuals to have health insurance, effective 2010.

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