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Health and Consequences

A story about health care reform efforts in Vermont references a provision Sanders put in the ACA allowing states to innovate.


Published March 24, 2010 at 9:13 a.m.

Fair Game is Seven Days’ weekly political column.

Health care reform finally passed in Washington, D.C. So it’s over, right? Wrong.

Vermont senators are tackling the issue this week in Montpelier. Thanks to a provision in the law championed by Sen. Bernie Sanders (I-VT), states can chart their own courses to universal coverage provided they meet the federal standards.

Another provision, negotiated by Sen. Patrick Leahy (D-VT), will allow Vermont to recoup about $100 million over the next 10 years as a reward for already enacting some of the federal standards, including expanded coverage to the uninsured.

While some conservative states are vowing to fend off the federal health care reform measure in court, Vermont lawmakers hope to take it further — much further. To that end, three of the five Democratic candidates for governor have different prescriptions.

Last week, one of the world’s leading health care system architects, Dr. William Hsiau, spoke to the House and Senate health care committees at the invitation of Senate President Pro Tem Peter Shumlin.

Hsiau lauded Vermont’s efforts over the decades: the Blueprint for Health, Catamount, Dr. Dynasaur, to name a few. “But it’s not a system,” said Hsiau. “They are patches of a quilt, but you haven’t decided what the quilt will look like.”

Senate Health and Welfare Commit-tee Chairman Doug Racine (D-Chittenden) said Hsiau’s comments support legislation he is sponsoring.

Racine wants to create a five-member panel that would provide the legislature with three system options, one of which would be single payer. Two members of the panel would be appointed by the governor, two by the legislature and one by the panel.

Some folks think that gives current Gov. Jim Douglas — an opponent of publicly funded health care systems — too much say.

No objections from James Haslam, executive director of the Vermont Workers’ Center and leader of the Health Care as a Human Right campaign.

“We’re very excited that this bill is moving forward,” Haslam said of Racine’s plan. “We’ve been working real hard to get to a place where we stop studying and actually move to implementation. This bill does that.”

Shumlin thinks the Legislature should scrap the idea of a panel and hire Hsiau to design a health care system for Vermont, and pay him out of funds already being spent on the languishing Commission on Health Care Reform, which helped design the Blueprint and Catamount systems. The commission will cost a whopping $218,745 to staff in FY 2011. Additionally, the state pays an IT health care consultant $149,700 to help deal with electronic records policies, among other issues, that relate to “health care reform.”

Sen. Susan Bartlett (D-Lamoille), who is also running for governor, has a different prognosis. Her Appropriations Committee is currently working on Racine’s health care reform proposal, which calls for $300,000 to fund its work.

Like Shumlin, Bartlett isn’t keen on the panel idea envisioned by Racine’s bill, nor does she like the price tag. “I’ll have some ideas later this week that I hope will be amenable to my colleagues,” said Bartlett.

In medicine, as in politics, there’s always a second opinion. And a third. And a fourth…

The Job of Jobs

Senate leaders will decide this week whether to accept changes to an $8.6 million spending plan of federal stimulus dollars — the “jobs bill” — or set up a special conference committee to hash out their differences with the House.

At issue are several key changes made by the House Commerce Committee, chaired by Rep. Bill Botzow (D-Pownal). The Senate Economic Development Committee crafted the original bill under the leadership of Sen. Vince Illuzzi (R-Essex/Orleans).

For starters, the House excised $100,000 for the Vermont Film Commission. The Senate had put the money in to save it from the Douglas budget axe. Botzow said he expects the commission will get its appropriation in some other part of the budget. Ditto a $100,000 downtown tax credit program the reps removed from the Senate version.

The House also cut $70,000 that would have started a statewide paramedic training program at Vermont Technical College, and $150,000 for an aviation tech center at Burlington International Airport. Also on the House floor: $300,000 from the Senate’s $800,000 line item to help businesses affected by the Champlain Bridge closure.

The Senate put in $2 million to expand rural broadband, while the House liked the $3.165 million figure better. The difference? Illuzzi’s committee wants the Vermont Telecommunications Authority to own the infrastructure and then lease it back to the private telecoms to provide services. The House version follows the Douglas proposal to subsidize Comcast, FairPoint and other telecom providers to build so-called “last mile” broadband.

“We looked at the VTA proposal and found it very convoluted,” said Illuzzi. “Besides, why should we be subsidizing these companies who are supposed to be building out their networks and never have and probably never will? People don’t care who they buy the service from; they just want the service.”

Good point.

Exemptions R Us

Ever wonder about the dollar value of Vermont’s tax exemptions, tax credits and other tweaks? For a policy geek like me, the answer is yes.

The House Ways and Means Committee and the Legislative Joint Fiscal Office have accounted for $1 billion that taxpayers aren’t sending to Montpelier.

“That a lot of bananas,” quipped Chairman Michael Obuchowski (D-Rockingham). And that number could double when you factor in federal pass-through exemptions and fully account for all state loopholes. Some tax credits and exemptions have not yet been calculated.

Out of that $1 billion, Obuchowski hopes to eliminate between $3.5 and $8 million in credits to help close the $150 million budget gap.

“Often tax expenditures are enacted to provide tax relief or economic stimulus, and they can encourage certain behaviors, but it’s a big chunk of money and Vermonters should understand where it goes,” said Obuchowski.

Former Rep. Mary Peterson (D-Williston) started working on this bill in 2005. The late Rep. Rick Hube (R-Londonderry) also championed it over the years.

The biggest sales and use tax exemptions include: $323 million for business machinery and equipment, $22.7 million for clothing and footwear, $54 million for home heating, $50 million for prescription drugs, and $78 million for food. Tax exemptions on groceries amount to an additional $113 million.

The biggest property tax exemptions include: $167 million in income-sensitivity payments; $25 million for public, pious and charitable groups; $40 million in current use; $14.9 million on state and federal buildings, and $7.8 million for the University of Vermont. By comparison, Vermont State Colleges are only exempted $898,000.

This week, the Ways and Means Committee is putting these exemptions into a single bill. Next week, the House will debate the measure on the floor.

Not sure how charitable the reps are feeling.

New Lease on Life?

After weeks of bad reports, there was a bit of good news last week for Burlington Telecom: CitiCapital told city officials they will draw down $380,000 from a $1 million reserve fund to cover BT’s missed February lease payment.

By using the money, CitiCapital ensures that BT will not default on its lease — for now. But BT isn’t out of the financial woods yet. Another $380,000 lease payment looms in May, and there’s still an ongoing probe by state regulators, a criminal review and a citizen lawsuit that aims to force repayment of the entire $17 million Burlington taxpayers unwittingly loaned BT.

This week, the city is sending off its proposal to Google in an attempt to convince the computer giant to build a state-of-the-art telecom network in Burlington. It’s a national competition.

The Queen City is not the only Vermont entity courting Google.

The Vermont Telecommunications Authority is pitching Google on the idea of a statewide network rather than one single community. The VTA has about 50 of the state’s 251 towns onboard as supporters, with more on the way, said Tom Murray, VTA’s executive director.

“We don’t see our proposals as mutually exclusive,” said Joe Reinert, a spokesman for Mayor Bob Kiss. “In fact, we think by supporting each others’ proposals, perhaps we can get Google to at least visit Vermont.”

Fête Accompli

Poor ol’ Public Service Commissioner David O’Brien can’t seem to catch a break.

O’Brien’s 2008 holiday party was mentioned in last week’s Sunshine Week op-ed penned by Stowe Reporter Managing Editor Tom Kearney. The Vermont Press Association distributed the piece gratis to news outlets around the state.

Kearney’s missive extolled the need for greater transparency in government and the public’s right to know, and made an example of the “Fair Game” exposé of O’Brien’s holiday party with top energy officials, including former Entergy Veep Jay Thayer. Thayer has since been fired from his post for lying to regulators and legislators about underground pipes at Vermont Yankee. You know, the tritium-carrying kind.

The commish responded in a letter he sent to, which carried the piece.

“In hindsight I regret being forthcoming about my personal holiday party. I should have answered that it was no one’s business who visits my home.”

Good grief.

I’d like to remind readers that O’Brien wasn’t forthcoming about his party. He denied such a party ever occurred until confronted by reports from other attendees — including Robert Dostis, the outgoing chairman of the House Natural Resources Committee and an incoming exec at Green Mountain Power.

Wash, spin, rinse and repeat.