For the week ending Friday, April 27, 2001
This week started with a Monday afternoon press conference in House Speaker Walter Freed’s office, in which he and other members of the Republican leadership announced that they would put plans for Act 60 reform on hold for this legislative session. The announcement stemmed in part from doubt as to whether the bill advanced by the Committee on Ways and Means could be passed by the House, and in part on the Speaker’s belief that the House and Senate are too far apart in terms of their approach to dealing with the issue this year. Nevertheless, the Senate Committee on Finance has continued to move forward on a bill of their own, releasing a draft of their proposal on Thursday afternoon.
As the month of May rapidly approaches, pressure to adjourn begins to mount. The Senate is expected to debate the Capital Appropriations bill in the next week and possibly the Transportation bill. Once those bills have been approved only the budget remains. The real push to adjourn will begin as the Committees of Conference meet to resolve differences on these and other major pieces of legislation that have passed both bodies this session.
Joint Fiscal Office Presents Troubling Figures for Vermont Medicaid Program
Figures circulating around the State House from the Legislature’s Joint Fiscal Office (JFO) paint a bleak picture for the health of Vermont’s Medicaid program. About 20 percent of Vermont residents receive some form of health care from the State, a percentage of the population significantly greater than in surrounding states. The annual tab for these benefits is in the $180 million range. Recent figures from JFO project an estimated $1.5 million deficit in the Medicaid programs in the next fiscal year, a number that could grow to as much as $75 million in six years. Over the last twelve years, the Legislature has consistently expanding eligibility for Medicaid, moves that critics say has transformed the Medicaid program from a safety net for the elderly and poor to a middle class health care entitlement. Legislative leaders are likely to face some tough choices in the coming years; either raise taxes to support the existing level of benefits, or scale back eligibility and benefits of the programs. Neither is politically attractive, though inaction could prove to be far worse.
Medicaid Reimbursement
The Senate Appropriations Committee focused last week on the Capital Bill and the Transportation Bill with little attention paid to the Appropriations Bill. The Senate is in session starting Monday to dispense with these two major money bills, with the anticipation of spending the majority of the week on H.485, the Appropriations Bill. This is where the discussions on Medicaid reimbursement levels will be decided and it is anticipated that the committee will review the cost-shift language that VAHHS opposes in Sec. 123a (h). VAHHS lobbyists talked with Susan Gretkowski of the Health Care Administration late on Friday to develop a strategy to eliminate this section from the bill, which the Administration opposes as well. Individual hospital executives were assigned Senators on the Appropriations committee to discuss this issue, laying the groundwork for removal of 123a (h).
Professional Regulation
The House Committee on Government Operations is still working on the annual professional regulation bill and is anticipated to formally introduce this legislation this week. VAHHS has worked with committee members to strike out language requested by the Secretary of State that would have changed gross negligence to simple negligence for a single incident.
Open Meeting Law – H.158
The bill subjecting hospitals to open meeting law regulations has yet to be discussed again in the House Committee on General, Housing and Military Affairs. Considering the House spent the majority of last week working on bills before the full House, there has been little time for the committee to meet on this, or any other, issue. This is likely to continue for the remainder of the 2001 session.
Nurse Loan Forgiveness
Last week, the Senate Committee on Education voted out S.116, a proposal to institute the nurse loan forgiveness program for RNs and LPNs. This version has a $400,000 appropriation in it compared to the $200,000 that the House included in H.485, the Appropriations Bill.
Nursing Homes and Other Fees
Last week, the full House gave final approval to H.496, the annual fee bill that includes the nursing home bed tax. As passed the bill increases each hospital’s annual assessment for the Health Care Trust Fund from 3.3% to 3.6% of its net patient revenues.For nursing homes the annual assessment was increased to $2,768.69 per bed, up from 1,534.25 per bed previously. VAHHS worked with the Nursing Home Association and some members of the House Addison County delegation to get the inflation increase funded from the General Fund instead of from the additional bed tax dollars. However, in the end this did not happen and now the debate will more to the Senate.
Coming Up
House Committee on Appropriations – Having dispensed with most of their major issues for the year, the committee will begin this week with a focus on the Drug Court issue.House Committee on Health and Welfare – This committee will revisit the Fletcher Allen CON and H.416, the medical information and privacy bill.
Senate Committee on Appropriations – The committee will focus their attention on finalizing H.485, the Appropriations Bill.
Senate Committee on Health and Welfare – This committee will continue to focus on the House-passed prescription drug bill, H31.