For the week ending Friday, April 20, 2001
The fate of Act 60 reform is still uncertain, despite the Committee on Ways and Means having voted a bill, H.491, out of committee last week. Business groups and many members of the House continue to raise concerns regarding the bill’s proposal to increase the state sales tax from 5% to 6%. At this time, it appears these concerns are of significance enough to leave in doubt whether the sales tax would survive debate in before the full House. In light of these concerns, the Senate Committee on Finance has begun to draft its own Act 60 reform bill.
In the Senate, work is progressing on the three "money bills;" the FY 2002 State Appropriations, Capital Construction and Transportation Appropriations bills.
The Committee on Appropriations is expected to have the State Appropriations bill ready for debate by the full Senate in the next two weeks, and the other "money bills" should be ready within the same time period. In floor action, the Senate debated S.27, legislation that makes changes to Vermont’s on-site septic disposal laws.
Act 60 reform continues to be the key to an orderly and timely adjournment this year. It is becoming clearer by the day that the House must make a decision as to how to proceed on this issue within the next week, if the legislature is to have any hope of adjourning sometime in May.
Equitable Medicaid Reimbursement and the Medical Fiscal Deficit
The Senate Committee on Health and Welfare, this week, briefly discussed a new legislative draft pertaining to Medicaid reimbursement. Included in this draft is a provision stating that within four years the State will adopt a fiscal strategy and appropriations to eliminate cost shifting and under-reimbursement in the Medicaid program. The Administration is very concerned about this provision, as it is unclear whether the intent is to eliminate cost-shifting within four years, or to just adopt a strategy to deal with cost-shifting. In addition, the Administration is certainly not comfortable with the mandate, as it believes that there must be a partnership between the Executive branch and the Legislative branch to accomplish this objective. VAHHS has continually urged legislators to understand the difference between eliminating the cost-shift and reducing it, especially if the goal is get Medicaid reimbursement rates on parity with Medicare.
Prescription Drug Cost Containment and Affordable Access
The original House bill, H.31, introduced by Rep. Tom Koch (R-Barre Town) in February, was discussed extensively in the House Committee on Appropriations this week. In the end, though there were some changes made to the bill, scaling back the appropriations to less than half as proposed by the House Committee on Health and Welfare. The House Committee on Appropriations voted out the bill on Thursday by a vote of 11-0.At the same time the House is preparing to bring H.31 to the floor, the Senate Health and Welfare Committee is hard at work discussing the issue as well. The Committee is in the process of comparing H.31 and S.135, the bill introduced in the Senate by Sens. Cheryl Rivers (D-Windsor), Susan Bartlett (D-Lamoille) and others. The members are considering the provisions in each bill to determine what they would like to have included in their version of the bill. It is apparent that H.31 is a tighter, clearer bill, so the committee is working from that bill. However, there is still much in S.135 that is not included in H.31, and the members are carefully reviewing both bills.
The most controversial part of S.135, the price regulation strategy for pharmaceuticals, was discussed in the Senate Committee on Health and Welfare early this week. The members agreed unanimously to not include this provision in their version of the bill. Not only has this issue been the deal breaker in years past, as Sen. Chard mentioned, but also other members were concerned about the constitutionality of this provision. Therefore, although they cannot be sure what will happen when the bill gets out of their committee, price regulation will not be included in this draft.
Professional Regulation
The House Committee on Government Operations has been working on legislation presented to the Committee by the Secretary of State’s Office of Professional Regulation (OPR) that makes various statutory changes to the licensing statues of the professions under control of OPR. Of specific concern to VAHHS is language proposed by OPR that would amend existing law dealing with the laws of unprofessional conduct for individuals licensed by OPR. Under current law, if a complaint for unprofessional conduct is brought to a professional licensing board, a showing of gross negligence must be found in order for the licensee to be disciplined. The OPR is suggesting language to lower the legal threshold for unprofessional conduct to what is essentially a simple negligence standard. Were this language to go into effect, only one error would be sufficient to show unprofessional conduct, placing a licensee in jeopardy of discipline and perhaps the loss of license. VAHHS testified in opposition to this language, and many other licensed professions are lining up to oppose this proposal. The Committee appears to be sympathetic to VAHHS’ concerns, and is expected to continue to review this issue this week.
Coming Up
House Committee on Appropriations –The Committee recently approved H.31, An Act Relating to Prescription Drug Pricing, which is up for consideration in the House this week. No other information relative to the Committee’s agenda was available as of noon Monday.House Committee on Health and Welfare –As stated above, H.31 will be under consideration in the House, thus members of the Committee will be involved in the debate on this bill for at least parts of the day on Tuesday and Wednesday. No other information relative to the Committee’s agenda was available as of noon Monday.
House Committee on Government Operations – The Committee is scheduled to address the draft legislation from the Office of Professional Regulation from 11:00 a.m. to 12:00 noon and then again starting at 2:45 p.m. on Tuesday.
Senate Committee on Appropriations –The Committee is scheduled to Mark-Up the FY 2002 State Appropriations Bill every afternoon this week.
Senate Committee on Health and Welfare – The Committee’s agenda was not available as of noon on Monday.