March 19, 2014

 Vermont Digger

The Vermont Senate doesn’t intend to sit on its hands when it comes to health care reform this session.

Frustration with the troubled rollout of Vermont Health Connect has undermined public confidence in the state’s ability to execute reform plans, and senators say they are intent on ensuring the same mistakes aren’t repeated in the transition to a universal publicly financed health care system.

That same experience has left the Shumlin administration cagey about releasing work products related to Green Mountain Care that might not be ready for public scrutiny, or even setting hard deadlines for their release.

Those were among the reasons Shumlin gave last week when he announced that the administration would not present a financing plan for the program this year.

Democratic senators, who are mindful of toeing the party line and don’t want to create problems for the governor or a program they support, still want to make meaningful progress toward universal health care this session.

“Typically there’s an administration piece of legislation that guides the Legislature’s thinking around health care, and this year there isn’t,” said Sen. Tim Ashe, D/P-Chittenden, chair of Senate Finance.

Ashe and other senators denied any frustration with the administration over the lack of guidance only three years out from a monumental transition in the state’s health care system.

“I think every administration wants to be the primary decision maker on the big picture policy areas,” Ashe said. “We know what our role is and we know what their role is, and so we’re trying to give the best policy guidance now where it’s appropriate.”

To that end, senators on the Finance and Health and Welfare committees plan to take an existing bill from the House, scrap it and use it to introduce legislation they hope will achieve that goal.

It will flag areas of reform they can move forward with legislation this session and what areas they need to better understand before legislating, Ashe said.

He plans to introduce a draft bill in committee Thursday and gather input from administration officials involved in health care during the rest of the week.

The legislation will attempt to create better oversight for upcoming health IT projects, clarify what questions lawmakers need answered to define the Green Mountain Care benefits package and develop a process and timeline for hiring a third party to administer the program.

Sen. Claire Ayer, D-Addison, called Health Reform Director Robin Lunge into the Health and Welfare Committee Wednesday to get feedback on a preliminary sketch of what they would try to accomplish with their bill.

The bill would require bids for third party administration to go out by July 1, 2015; contracts would be awarded by Dec. 15, 2015. Ashe has also expressed interest in putting dates for hiring a third-party administrator in statute.

Lunge said that would be setting the administration up for failure, and wouldn’t help lawmakers achieve their goals.

“What I wouldn’t want is to have artificial deadlines that I either have to miss, because it’s in statute, or that I have to worry about coming back through the legislative process to change as we get closer, because I want to make sure we get it right,” Lunge said.

A better way to move forward would be for legislators to request an operations plan by a certain date that Lunge and the administration could then provide to help legislators make informed decisions.

The administration is gathering much of the information that will inform policy decisions; by controlling the flow of that information to lawmakers it can affect when decisions are made.

“The flip side, Robin, is there’s some difficult political decisions we have to make, and we want to be ready to make those decisions,” Ayer said. “It needs to be a compromise between not pushing ourselves to go forward when we’re not ready, but pushing ourselves to be ready.”

Sen. Anthony Polina, D/P/W-Washington, agreed.

“We can only do so much before we hear more from the administration,” he told Lunge. “I don’t want to find out that I have to make a decision in a week, when I’ve been waiting three years to see a plan.”