$12 Million health care bill heads toward final approval in the House

The Vermont House gave preliminary approval Thursday to an omnibus health care package that raises $12 million supporters say will strengthen primary care and increase access to medical services. A final vote is scheduled for Friday.

The bill also sets out contingencies should new technology releases for Vermont Health Connect fail to improve its performance, and includes a range of policy initiatives aimed at furthering structural reforms to the state’s health care system.

Debate on the package lasted for more than four hours and grew heated at times, with lawmakers from both sides of the aisle — though mostly Republicans — calling for seven separate roll call votes.

Rep. Bill Lippert, D-Hinesburg, chairman of the House Health Care Committee, said Vermont has taken steps in recent years to address rising health care costs and expand access to medical services. Those efforts “have been controversial, some have been successful and some have foundered,” Lippert said, citing among the successes Vermont’s reduced uninsured rate (second lowest in the U.S.),  state regulators’ role in reducing the growth in overall spending and savings, and improved patient outcomes through the Blueprint for Health managed care program.

But the state “still has much to do,” he said, and the bill under consideration prioritizes helping underinsured residents access medical services, primarily through increased Medicaid payments to primary care providers and increased subsidies to reduce the out-of-pocket costs of exchange coverage for middle- and low-income Vermonters.

The $12 million is raised by expanding the sales tax to include candy and soda, a measure opposed by Gov. Peter Shumlin. It also includes an expansion of the meals tax to vending machine food and drink, increases the cigarette tax by 33 cents over two years, and applies a similar increase to the “floor stock tax” on other tobacco products such as snuff and snus.

Republicans decried the additional tax increases beyond the roughly $35 million in new taxes already in the House-passed budget, but praised the VHC contingency measures. A roll call vote on the amendment containing the tax hike passed 78-62, while a roll call vote on the amendment with the contingencies passed 139-1.

“When do all the taxes stop? Most Vermonters are taxed to the max — I vote no,” said Rep. Ronald Hubert, R-Milton.

A few minutes later, after the roll call vote containing the exchange contingencies, Minority Leader Don Turner, R-Milton, said, “This action is long overdue. It’s time the Legislature recognized that the exchange may never work as intended.”

The VHC contingencies require the administration to make regular reports to the Legislature while it’s out of session.