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Killed Bill: Senate Panel Deals Blow to Health Care Reform

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Fair Game is Seven Days’ weekly political column.
Sen. Tim Ashe - FILE: JEB WALLACE-BRODEUR
  • File: Jeb Wallace-Brodeur
  • Sen. Tim Ashe

When Democrat Peter Shumlin became governor in 2011, he carried the promise of a single-payer health care system for Vermont. Less than four years later, he abandoned his central policy goal. On Friday, a Democrat-dominated legislative committee balked at a much less comprehensive idea. For health care reform advocates, it was yet another blow.

Earlier this month, the Senate Health and Welfare Committee approved S.53, a bill that would set a path to publicly funded universal primary care for Vermonters. But then it went to the Senate Appropriations Committee, which essentially gutted the proposal. Its version simply calls for a study of the concept.

Don't think we'll be revisiting single-payer anytime soon.

"I think people have a form of PTSD on health care," said Senate Health and Welfare chair Claire Ayer (D-Addison). Her panel spent more than a year on S.53. But early Friday evening, she watched that work go up in smoke. By her account, she'd asked to testify before the Appropriations Committee. Instead, the panel adjourned for an hour and came back with a new version, which it quickly approved. The substitute bill was dubbed the Kitchel amendment, for Appropriations chair Jane Kitchel (D-Caledonia), but she said it was actually written by Senate President Pro Tempore Tim Ashe (D/P-Chittenden), who is a member of her committee.

Universal care advocates took to social media, trying to spark a last-ditch rally. "We want the amendment defeated and the original bill passed," said Dr. Deb Richter, a veteran single-payer advocate. But a reversal seems very unlikely.Indeed, as of Tuesday afternoon Ayer was floating a compromise that essentially adopts the Ashe formulation.

Even the bill rejected by Appropriations was a major retreat from S.53 as it was introduced in early 2017. It called for a universal primary care system in Vermont by January 2019, and it had 13 co-sponsors.

Thirteen. That's nearly half the Senate — only three votes shy of a majority.

By contrast, the bill that emerged from Ayer's committee simply stated the legislature's intent to create a universal, publicly financed primary care system by January 2022. And there were plenty of conditions, such as identifying a funding source, ensuring there would be no new paperwork for providers and paying adequately for primary care.

Those caveats would give future legislatures plenty of chances to pull the plug. Still, that "intent" language was too much for Senate Appropriations to swallow.

"I'm not ready to commit to a publicly financed insurance product," Ashe said in an interview. He acknowledged that there were "off-ramps" but opposed the statement of intent. "Intent language doesn't have full force, but it does state that the legislature favors this particular outcome."

On this issue, the chamber's Democratic/Progressive leader finds himself in league with the moderates in his caucus.

The new Appropriations Committee bill calls on the Green Mountain Care Board, which regulates hospital and insurance costs, to explore how to achieve universal primary care "whether publicly financed or covered by health insurance or other means."

Two items of note: First, the bill abandons any commitment to public funding. And second, it gives the issue to a board that's packed with Republican Gov. Phil Scott's appointees — and his administration is no friend to publicly financed health care. Seems like a prescription for a negative report come January.

Ashe and Kitchel protested that they did the best they could, having received the bill just before the deadline for moving legislation out of committee. "We needed to get the bill out, and most members were not ready to say they had settled on a particular method of doing [universal primary care]," Ashe said.

Ayer begs to differ. "They could have taken testimony before they officially received the bill," she responded. "They knew it was coming. I kept the pro tem informed."

Ayer is right; it's not uncommon for committees to take testimony before actually receiving a bill. Besides, in theory, Appropriations' only role is to vet the money portion of a bill. According to the legislature's fiscal experts, Ayer's legislation would have cost $5,500 at most in the new fiscal year.

In truth, Kitchel's panel did what it claims not to do: It made a policy decision. Members didn't like the substance of a bill, so they rewrote it. Ayer does have the authority to restore the bill in her committee, but she knows that further compromise will be required if she wants to get a bill through the Senate. An already watered-down piece of legislation will be diluted once again.

And the single-payer vision seems more distant than ever.

Reason Prevails

Last week was a combustible time in the Vermont House. Its money committees were trying to approve the session's big bills: budget, taxes and capital spending. It was a particularly dangerous moment to suddenly toss in a big bag of unclaimed loot. "You're worried about a feeding frenzy," said House Speaker Mitzi Johnson (D-South Hero). But everyone handled it with diligence and restraint.

The money in question, roughly $28 million, arrives from the universal tobacco settlement that's been providing a yearly influx of funds since it was signed in 1997. Where did this one-time money come from?

The 1997 settlement covered large tobacco makers; some smaller firms were not included. So Big Tobacco has an interest in diligent enforcement of state tobacco laws to keep the little guys in check. States that do so are eligible for extra dollars. But calculating that benefit can involve years of litigation. In fact, Vermont had unsettled claims dating back to the year 2004.

"We've been working on this for a long time; it predates my tenure in office," said Attorney General T.J. Donovan, who was elected in 2016. Two weeks ago, his office finally nailed down a deal that would settle claims from 2004 to 2017.

At that point, Donovan had a plan. "I figured it was a great opportunity to talk to legislative leaders and the governor's office about earmarking money for opiate programs," he said.

"The attorney general called us," recalled Jason Gibbs, Gov. Scott's chief of staff. "He was interested in devoting a portion to opiate prevention and treatment. The conversation occurred over five to six days."

"I got a call — it was Town Meeting Week — from the attorney general describing the settlement," said Ashe. "There was a general sense that breaking the money out in half for addiction-related activities made sense."

Johnson explained the thinking. "The money came from companies that knew their product caused damage," she observed. "I think it's appropriate to use that settlement money to address all forms of addiction."

Conversations continued into last week. The administration, surprisingly, didn't lay claim to the other half of the money. "Letting the legislature appropriate the rest was politically and practically a good approach," Gibbs argued.

The action then moved to the House, which is considering next year's budget. "I spoke with the relevant people in the House, and there was interest," said Johnson. Lawmakers agreed to spread the $14 million for opiate programs over four years to avoid a boom-and-bust phenomenon. Most of the remaining $14 million was earmarked for the teacher pension fund and the state's rainy day fund.

After the House approves a budget, the action moves to the Senate. And while there's broad agreement between the two chambers, the details may work out differently. Regarding the opiate money, Ashe said, "We have a number of areas where temporary funds could come in handy to help meet the needs."

He was circumspect on the House's ideas for the other $14 million. "We'll consider those," he said. "None of those ideas is a bad idea. It's just a matter of competing priorities."

But so far, as Gibbs noted, dealing with a $28 million windfall has been "an oasis of bipartisanship."

No feeding frenzy here.

Sleepy Statewides

Last Thursday marked the first campaign finance reporting deadline for state political candidates since last July. Almost all the attention was focused on the gubernatorial race, where incumbent Republican Phil Scott reported raising $108,000 over the past nine months. Republican challenger Keith Stern raised $28,000, the bulk of it from his own back pocket. Recent Democratic entrant Christine Hallquist raised $43,000 in the opening three weeks of her campaign, while fellow Democrat James Ehlers raised $19,000 over nine months.

A check of the other statewide races — lieutenant governor, attorney general, treasurer, secretary of state and auditor — showed precious little activity. The most notable thing was the lack of Republican candidates for any of the five offices, all currently held by Democrats or Dem/Progs. It's not too late for Republicans to emerge, but time's a-wastin'.

Generally speaking, state legislative races have yet to get underway. If all seats were contested, there could be hundreds of candidates. Only 92 have filed, and almost half of those reported no activity.

The most striking report came from southeastern Vermont. Sara Coffey, founder and director of the Vermont Performance Lab, a "performance incubator" located in Guilford, has raised almost $10,000 as a Democratic candidate for the Windham-1 House seat. Its four-term Republican incumbent, Mike Hebert, hasn't had a Democratic opponent since 2010.

Ten thousand dollars is a huge amount for any Vermont House race, let alone in the early stages of a campaign in a rural district. A Republican-leaning district, at that. Coffey did not return calls for comment, but this one is worth keeping an eye on.

Media Notes

Channel 3 is losing another familiar face. WCAX-TV anchor/reporter Kristin Kelly is leaving the bright lights of television for the more lucrative field of corporate PR. In fact, she will join her former Channel 3 colleague Kristin Carlson at Green Mountain Power. Carlson will move from communications to regulatory management, while Kelly will take over Carlson's current role.

Kelly worked at WCAX as a reporter from 1996 to 2002, when she took a job with New England Cable News. She returned to Channel 3 in 2005 to become co-anchor of "The Channel 3 News at 6." She's been there ever since, working first with Marselis Parsons and then Darren Perron.

"It will be hard to leave here," Kelly said in a statement released by WCAX. "Channel 3 has been a huge part of my life."

Her last day on set will be March 30; news director Roger Garrity said there are no plans yet for a permanent replacement.

Disclosure: Tim Ashe is the domestic partner of Seven Days publisher and coeditor Paula Routly. Find our conflict-of-interest policy here: sevendaysvt.com/disclosure.


The original print version of this article was headlined "Killed Bill"

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