For the Week Ending February 3, 2012
Members of the House Health Care Committee expressed disappointment that the format for their joint public hearing with Senate committees last Wednesday evening prevented a give and take conversation with employers commenting on the development of Vermont’s new health insurance exchange. The meeting format had employers delivering short remarks and allowed only clarifying questions. Some committee members felt that some of the employers’ concerns could have been addressed with an open discussion.

However, the concerns expressed by a majority of those employers providing testimony prompted the committee to verify its own understanding of the requirements in the federal law establishing exchanges by 2014. The committee invited the administration’s director of health reform to revisit the federal requirements for the exchange and the individual and small group markets and clarify decisions that state’s may make.

The committee will hear testimony this week on those sections of H.559 relating to the exchange and changes to the state’s individual and small group insurance markets. Lawmakers must decide whether to merge the individual and small group markets, whether to allow a market outside the exchange, and whether to define small groups as less than 50 employees as in current law or less than 100 employees in 2014 rather than in 2016. Employers attending the public hearing expressed concern with rising health care costs and the negative impacts on their businesses, but worried that the state would take away their choices for low cost benefits by not allowing off-exchange options for products like low-cost high-deductible HSAs.

The committee last week approved a provision in H.559 to prohibit discretionary clauses in health insurance contracts that had allowed insurers to interpret the benefit provisions in the contract. The committee decided not to include a provision limiting prescription drug out-of-pocket costs to $1,000 after hearing opposition from insurers and pharmacy benefit managers. A two-step regulatory process for insurer rates and hospital budgets was approved using existing BISHCA processes as a first step and Green Mountain Care Board review to include access and affordability criteria in a second step for final approval. 

Meanwhile last week, the Senate Health and Welfare Committee took introductory testimony on several bills sponsored by committee members to determine if those bills warrant further consideration. The committee heard proponents of bills to require expanded reporting from health insurance companies (S.200), expand a recently-passed autism mandate to cover all ages (S.223), and a bill to remove a loophole in the state’s law requiring immunizations for students to enroll in the state’s schools (S.199).

New Bills of Interest:

H.672 Introduced by Representative Savage of Swanton and others

This bill proposes to ensure that consumers have an option to purchase prescription drugs from either a retail pharmacy or a mail order pharmacy.

H.674 Introduced by representative Canfield of Fair Haven and others

This bill proposes to enumerate the rights of pharmacists and pharmacies during an audit, as well as to specify their appeal rights and the process for any recoupment of disputed funds.

H.735 Introduced by representatives Olsen of Jamaica and Wilson of Manchester

This bill proposes to establish a discounted premium rate for beneficiaries based on whether beneficiaries are nonsmokers or smokers who participate in a tobacco cessation program.  

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