2006 Legislative Updates:

 April 28, 2006

The conference committee has been meeting this week to hammer out the differences between the Senate and House versions of H.861 - Health Care Affordability Act for Vermonters. By all accounts the two sides are very close. Less clear is the extent of the negotiations between the conferees and the administration. Here are the items in play:

Catamount Health: The mechanism for offering Catamount Health would be determined in a two step process:

Plan A - A minimum standard package of benefits would be defined. Insurance companies would offer an insurance policy built on that standard. However, insurers would not be mandated to participate. The premium amounts would be subject to legislative oversight. If approved, each insurer would be able to offer one insurance product. The insurers would be required to assume all the risk and the benefit packages would need to be "actuarially equivalent" to BCBS plan G. The original $250 deductible would be increased to $500 but there would be no deductibles or co-pays for preventive care. Each insurer would have their own pool of covered lives -- although a common pool is being discussed. Insurers would reimburse providers at cost plus 10%.

Plan B - If no insurer elects to participate or there are no approved plans, then the state would contract with a 3rd party to administer a plan with the state assuming the risk.

Employer Assessment - The House will probably agree to this Senate provision. For each full time equivalent (FTE) employee not covered, the employer would pay a $365 per employee per year assessment. The conferees agreed to increase the number of exempt FTE's from 3 to 4. The assessment would start with the implementation of Catamount Health and not be delayed as previously envisioned.

Legislative oversight of Catamount Health would be significant and well-defined in the legislation.

Chronic care and BluePrint initiatives remain without major changes.

Process for capping enrollment in Catamount health, if funds were not sufficient, would remain in the legislation.

Next meeting: The conference committee will meet Monday afternoon, May 1st. Most statehouse observers expect the major issues will be resolved and conferees would vote on the new language late Monday or early Tuesday. Then, each legislative body would vote to accept or reject the conference report. By suspending the rules, this process can happen within a day or two.

Adjournment: Besides health care reform, there are several other bills that must be passed -- including the budget, energy and transportation legislation. Leadership would like to adjourn the session by the end of the week.

Governor: There is no consensus among Statehouse lobbyists about whether or not the governor will sign or veto H.861 or the other outstanding bills. There is general agreement that he will sign S.310 -- the Common Sense Initiatives.

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Vermont Health Care for All would like to thank VPIRG for their generous support of the 2006 Legislative Updates. They are also available on the VPIRG website http://www.vpirg.org. They will be produced throughout the 2006 Legislative session by Paul Forlenza. Forlenza can be contacted at paul@forlenza.us or 802-453-3592.