Shumlin pitches single-payer to legislators

January 08, 2014

Rutland Herald

By Neal P. Goswami
Vermont Press Bureau

MONTPELIER — Gov. Peter Shumlin took the rare step of appearing before a legislative panel on the opening day of the legislative session, reasserting his commitment to a single-payer health-care system.

The state is in the midst of implementing Vermont Health Connect, the state-operated online health- insurance marketplace required under the federal Affordable Care Act. But Shumlin said current reform efforts are simply “nibbling around the edges.”

Providing universal coverage while curbing costs will require a bolder plan, he said.

Shumlin took to a podium in a packed hearing room at the State House on Tuesday to address the House Health Care and Senate Health and Welfare committees. He told lawmakers the Affordable Care Act is “a product of Washington compromise, imposed on the states after a contentious fight in Congress.”

Troubles surrounding the rollout of the state’s exchange are well-documented. The website failed to work for nearly everyone who tried to sign up in its first few weeks, prompting Shumlin to allow individuals and small businesses to extend their existing health coverage into 2014.

The additional options introduced by Shumlin, as well as an improved site, have led about 54,000 Vermonters to enroll in exchange plans.

But the online payment system for premiums is still not functioning, and small businesses cannot yet enroll directly through the exchange site.

Shumlin said Tuesday he accepts responsibility for the site’s failings but reiterated that the state’s main contractor, CGI Systems and Technologies, failed to meet its promises. He told the joint meeting that he has authorized hiring an independent group to review the exchange rollout and report on what went wrong.

Shumlin also said Lawrence Miller, secretary of commerce and community development, will lend a hand to the Department of Vermont Health Access over the next several months. Miller “has years of practical project management and business experience,” the governor said.

The request for additional help in addressing exchange challenges was made by DVHA Commissioner Mark Larson, who will spend much of his time testifying before lawmakers in the next few months, according to Shumlin.

A Shumlin aide said Miller will retain his position as secretary but that Deputy Secretary Lucy Leriche will take over day-to-day operations of the agency while Miller assists with exchange issues.

Shumlin, who had asked to address the committees, rejected any notion that the exchange’s woes have deterred him from an ambitious goal to transition the state to a publicly financed single-payer system in 2017.

“Let me be very clear: I have never been more convinced of the need to keep moving forward,” he said. “I have never been more certain that the path we’re on is the right one. And I have never been more committed to ushering in America’s first universal, affordable, publicly financed health care system right here in Vermont.”

Current health care reform efforts have brought some improvements, Shumlin said, but it remains “a teetering patchwork of payers, providers and consumers that costs too much for too many and fails to cover everyone.”

He added, “It is still full of skewed incentives that reward volume above good health. It is still a system no one in their right mind would develop from scratch. And it is still a system that spends money faster than we can earn it.”

The state will not push forward with a single-payer plan, Shumlin said, “unless we can assure ourselves that it will be sustainable, bend the cost curve and help create jobs.”

Shumlin urged lawmakers to begin defining how the state will finance his health care plan.

“To do this we should look at the current system and question: Who is asked to pay where, when, why and how,” the governor said. “We should look at how regressive and unfair the current system is. And we should embark on the path of designing a new system that is built upon equity, fairness and common sense.”

Shumlin’s most prominent health care critic, Darcie Johnston, head of Vermonters for Health Care Freedom, said his march toward a single-payer system could be catastrophic to the state’s economy.

“We want affordable access to health care for all Vermonters, but this is about the right way to get there without destroying Vermont’s economy,” she said.

Johnston said Shumlin’s call for an independent review falls flat because the request for proposals has been sent to the state’s preferred bidders.

“This is just a smoke screen at Vermonters’ expense because the governor can’t step up and take responsibility and hold somebody accountable,” she said.

And Johnston said Miller is “absolutely … the wrong person” to assist the Department of Vermont Health Access with the exchange. He should instead focus on needed economic development across the state, she said.

“He cannot do that (while) trying to right the Vermont Health Connect ship,” Johnston said.