For the Week Ending January 13, 2012

The House Health Care Committee this week will begin hearings on the administration’s health care reform bill for the 2012 session, H.559. The bill will be introduced in the House tomorrow (Tuesday) and administration officials will provide a series of briefings throughout the week.

Legislative committees responsible for Vermont’s health care reform efforts spent last week hearing reform updates in preparation for H.559 and the delivery of several reports and studies that will enable the legislature to make decisions on key aspects for a health insurance exchange required by federal health reform law in 2014 and keep the state on track toward a single-payer system in 2017. Those reports and studies will provide the back-up to the administration’s recommendations included in H.559.

Also last week, the House Health Care Committee received overviews of the state’s current private health insurance market from BISHCA and an explanation of the changes required by the federal Affordable Care Act from the state’s director of health care reform. The committee heard strong hints about some of the recommendations that will be included in the recommendations due this week, including that the administration will recommend that employer groups of up to 100 employees should be in the exchange when it becomes operational in 2014 and that there should be no private market outside the exchange.

Administration officials also revealed in a joint hearing of the House Health Care and Senate Health and Welfare committees late last week that they were leaning toward recommending adoption of a federally-authorized “basic health plan” for Vermonters with incomes up to 133 percent of the poverty level under the state’s Medicaid plan rather than have that population receive federal premium subsidies and receive their coverage through the exchange. The administration was changing its mind, the committees were told, because they now have optimism that the state’s Medicaid plan may receive federal approval as an MCO (managed care organization). Some experts and legislators worry that the exchange has the best chance for sustainable success if it has sufficient enrollment and that diverting potential enrollees into the Medicaid plan may jeopardize the long-term success of the exchange.

Both House and Senate Committees also heard a Green Mountain Care Board request for emergency rulemaking authority for them to immediately establish rules governing the process for their review and approval of insurer rate requests, hospital rate and budget approvals, and CON requests as required by Act 48. The request is included in the governor’s annual budget adjustment bill and sparked controversy over its necessity when BISHCA could continue those functions until the board completed the normal rulemaking process.

The Senate Health and Welfare Committee spent time last week on a review and updates on the state’s mental health system, budget adjustment requests regarding child abuse and nursing home visits, and descriptions of several Senate bills introduced this year.

This week, the Senate Health and Welfare Committee will tackle substance abuse treatment and mental health issues and later in the week join the House committee in joint session with the Green Mountain Care Board to discuss the health care reform strategic plan. The Senate Finance Committee has scheduled time with BISHCA officials to discuss their miscellaneous “housekeeping” bill.

New Bills of Interest:

H.527 Introduced by Representative Till and others

This bill proposes to eliminate a philosophical exemption from the requirement that all children attending school and child care facilities receive immunizations specified by the department of health.

H.559 Introduced by representatives Fisher of Lincoln and Pugh of South Burlington

This bill proposes to implement a number of changes to Vermont’s health insurance, health coverage, and health care provider regulatory frameworks, including: (1) defining a small employer for the first three years of the Vermont health benefit exchange as an employer with 100 employees or fewer; (2) merging the individual and small group insurance markets; (3) expanding the duties and clarifying the role of the Green Mountain Care board; (4) giving the Green Mountain Care board authority over the health insurer rate review, hospital budget review, and CON processes; (5) banning discretionary clauses in health insurance contracts; (6) restricting the amount of an insured’s out-of-pocket expenditures for prescription drugs; (7) authorizing the agency of human services to seek certain waivers from the Centers for Medicare and Medicaid Services; and (8) repealing Catamount Health and the Vermont health access plan upon implementation of the Vermont health benefit exchange.

If you are interested in this week’s Legislative Committee Meeting schedules, agendas, and a listing of other meetings and activities, please visit the Vermont Legislature’s website at http://www.leg.state.vt.us/Committee01.cfm Committee meetings are normally updated daily, and are subject to change without notice.  If you plan on attending, you may want to call ahead to verify the agenda.

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