For the Week Ending February 22, 2013 

A committee vote on a bill to establish state premium tax credits and cost-sharing subsidies for individuals purchasing insurance through the Vermont Health Benefit Exchange beginning in 2014 took an unexpected turn Friday when it died on a 5-5-1 tie vote. The bill also contained a controversial excise tax on sugar-sweetened beverages and repealed a health care assessment on employers, but those were not contributing factors in the bizarre turn of events.

A need for state subsidies in addition to federal subsidies available on the exchange became apparent last year when a financial analysis revealed that many Vermonters who now receive assistance for premiums and cost-sharing on Catamount Health and through the VHAP program would experience higher out-of-pocket costs beginning in January 2014. Catamount and VHAP are being eliminated to comply with federal law and those members will have to purchase coverage through the exchange.

Two committee members (a Progressive and an Independent) that had unsuccessfully tried to increase the level of state subsidies in earlier committee votes joined with the three Republican members who opposed a new tax on sugar-sweetened beverages to vote against the bill. House Democratic leaders opposed raising state subsidies above those recommended by the Governor and also do not support the beverage tax. The eleventh committee member is a Democratic member who also wanted higher subsidies, but left before the vote to attend to an “emergency.”

The strategic and tactical move by the members supporting higher subsidy levels was intended to force a concession from the committee and House leadership to allow higher subsidies. Members supporting the higher subsidies argued that the sugar tax would raise more than enough money to fund additional subsidies and those subsidies are necessary to avoid higher premium and out-of-pocket costs on the exchange for those people who currently receive benefits through VHAP and Catamount Health. Leadership is adamant about holding the subsidy expenditures to those recommended in the Governor’s budget proposal.

It won’t be known until this week if the Health Care Committee will reconsider and vote to resurrect the bill they have spent weeks developing. The absent Democratic committee member could return and vote with leadership to pass the bill or another House committee could take up the topic of additional state subsidies. Under House rules, the House Ways and Means Committee and the Appropriations Committee would have received the bill for their review of revenue and spending provisions anyway. There is nothing preventing those committees from creating their own bills to address these same issues.

Meanwhile, the Health Care Committee has scheduled this week for hearings on two “housekeeping” bills (H.107 & H.116) making adjustments to statutes related to the exchange.

The Senate Finance Committee last week unveiled a committee bill to change the health insurer rate review and approval process based on recommendations for the state Department of Financial Regulation and the Green Mountain Care Board. The legislature recently created a two-step process whereby DFR reviewed rate proposals and then recommended action to the Board who was given final approval authority. After a year’s experience, the board is recommending they control the process with input from DFR limited to insurer solvency.

The Finance Committee is scheduled to hear from insurers and other stakeholders this week about the restructuring.

New Bills of Interest:

H.310    Introduced by Representative Poirier of Barre City and Moran of Wardsboro
This bill proposes to require that to the extent permitted under the Affordable Care Act, implementing the Vermont health benefit exchange shall not impair the health care coverage provided to Vermonters through collective bargaining agreements entered into prior to January 1, 2013.

H.311    Introduced by Representative Browning of Arlington

This bill proposes to ensure that Vermont residents have the ability to enter into voluntary financial arrangements with their health care providers. It wouls also prevent the Green Mountain Care Board from placing restrictions on health care professionals’ practice locations.

H.315    Introduced by Representative Komline of Dorset and others

This bill proposes to require employers domiciled outside of Vermont to offer the same health coverage and benefits to employees with a same-sex spouse as to employees with an opposite-sex spouse.

H.332    Introduced by Representative Campion of Bennington

This bill proposes to require dental services to be part of the Green Mountain Care benefit package.

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