Health Care Package Shrinks Again

A house health care package has been pared down again as lawmakers careen toward adjournment. In all, lawmakers plan to raise $12 million for a health care bill that has languished in House Appropriations for several weeks.

What started out as Gov. Peter Shumlin’s grand plan to help poor Vermonters get better access to hospitals and physicians has shrunk over the past four months to an attempt to shore up a weakened primary care system and provide subsidies to low-income Vermonters.

Shumlin proposed a $90 million payroll tax that would have increased Medicaid reimbursements to health care providers by 20 percent. The governor has said too many Vermonters receiving Medicaid benefits are turned away because the reimbursement rate is too low.

But the House rejected the governor’s proposal. Instead, lawmakers have proposed scaled down versions of the package. First the funding proposal was $52 million, then it was bargained down to $22 million.

Now several members of the House Ways and Means Committee say leadership is zeroing in on $12 million in new revenue to increase Medicaid payments for primary care and subsidies offered through the state health care exchange, as well as several other less costly initiatives aimed at increasing access and reducing the cost of care over time.

The funding would come from a combination of increases to the sales tax for items such as soda, candy and cigarettes, and an increase to the employer assessment — a per employee tax on businesses that don’t offer health care or have employees that opt for Medicaid instead of the employer sponsored benefit, the committee members said.

Rep. Janet Ancel, D-Calais, would not confirm the $12 million figure or the precise taxes being considered, saying “we haven’t settled on something as a committee,” but she did affirm that efforts to “salvage” a health care package are underway. Rep. Mitzi Johnson, D-South Hero, chair of House Appropriations, and Rep. Bill Lippert, chair of House Health Care, were tight-lipped about the plan, too.