June 2, 2010 — UPDATE: In a recent statement, Vermont Governor James H. Douglas (R) laid out his conflicting opinions—on the state’s 2010 universal health care legislation—which lead to the ultimate decision not to sign or veto the measure. Included in the letter, SB 88:
+ Shows promise for quality improvement and cost reduction – representing the culmination of years of work by revising the state’s existing program, Blueprint for Health.
+ Articulates the components of the integrated medical home and community health team payment reform model.
+ Requires insurance carriers to participate in the statewide expansion of the Blueprint as a condition of doing business in the state.
+ Establishes interoperable connectivity through the state Health Information Exchange and a one-year primary care work force development committee.
+ Charges the Department of Banking, Insurance, Securities and Health Care Administration with limiting the rate of growth in hospital spending and insurance premiums.
– Has caused concerns among health care professionals regarding low-income residents’ access to free prescription samples.
– Mandates studies that are a “wasteful expense of time and scare resources, as Vermont would be prevented by the federal health care reform law from implementing any of the new ‘designs’ until 2017 at the earliest.”
– Jeopardizes Vermont’s participation in the CMS Advanced Primary Care Practice Medicare demo.
May 17, 2010 — UPDATE: Image from the Kaiser Commission on Medicaid and the Uninsured:
In Vermont, a state with more than 90 percent of residents insured and ranked #1 in the Commonwealth Fund’s most recent State Scorecard on Health System Performance, the legislature is close to adopting a change to the health care delivery system not accomplished by Congress—universal coverage. Both chambers of the state’s Democratic-controlled General Assembly passed different versions of SB 88—the original version of the bill, passed by the Senate, would establish a single-payer system. The House amended the legislation, replacing single-payer with a public option, which would allow the state to create a health insurance program to compete with private payers.
Legislators currently are working out the details in a conference committee. Governor Jim Douglas (R) has not yet indicated whether he will sign either version of the bill if it reaches his desk. The governor supports certain cost-containing provisions of the legislation but does not approve of either bill in its entirety. The state could not pursue such plans until 2017 as required by the new federal health care law.
Vermont, however, isn’t alone in its efforts. Minnesota SF 118 was introduced in 2009 but has received little attention from the Legislature in 2010. During the current legislative session, HB 767 and SB 682 were considered by the Maryland General Assembly but ultimately were reported as unfavorable by their respective initial committees of referral.
California also is considering a single payer bill, SB 810, which passed the state Senate and is under consideration in the Assembly. In a recent press release concerning federal health reform, Governor Arnold Schwarzenegger (R) indicated that he supports reform and expanding coverage. However, given the state’s current economic condition, adoption in 2010 seems unlikely.
Additional resources on universal health care in Vermont