For the week ending Friday, March 23, 2001
The House Committee on Appropriations this week approved the proposed FY 2002 state appropriations bill, H.485, proposing $872 million in state spending. The budget, which is set for debate in the House beginning Friday, includes increases in the Medicaid budget to address the existing cost shift and nearly $27 million for "one-time" expenditures in the coming fiscal year. Since this budget is the first one crafted by Republicans in sixteen years, it reflects different spending priorities to that of the Democrats. Debate over this budget was heated during second reading debate on Friday and is expected to continue on Monday as the House debates H.485 on third reading. Among them is a provision to help eliminate the sharing pool in Act 60.
In business issues, the Senate Committee on General Affairs and Housing is continuing work on S.161, legislation that proposes the creation of a new paid parental leave entitlement program (see related story). Also in the Senate, the Committee on Natural Resources and Energy began work on H.475, the Act 250 reform bill passed by the House last week. Prospects for this bill appear to be better this year, with committee chair Sen. Dick McCormack (D-Windsor) promising the bill a fair and complete hearing in the Senate.
In general, the pace of the legislature appears to have picked up since their return from the Town Meeting recess, however, there is much work yet to be done. This week, the House Committee on Appropriations is expected to take up H.31, legislation passed by the Committee on Health and Welfare to lower the cost of prescription drugs. With a $3 million price tag attached to it, the fate of this bill is less than certain. Failure to act on some type of prescription drug legislation could be damaging politically to House Republicans, as the Democrats in the Senate made clear during and since the elections that this is a major issue that should be dealt with during this biennium. In addition to the budget, the Senate still has at least two bills to consider that are priorities for the House leadership: Act 250 reform and the financial privacy bill, both of which will be fairly controversial. In all, both houses of the General Assembly have their work cut out for them if they are to meet their target adjournment date of April 21st.
Medicaid ReimbursementThe full House gave preliminary approval to H.485, the FY 2002 budget bill, which included a $4.1 million appropriation for relieving the Medicaid cost shift. As reported last week, language that would restrict hospitals’ ability to cost shift finally made it into the budget bill. For most of Thursday and Friday, VAHHS worked with House Health and Welfare Committee Chair Rep. Tom Koch (R-Barre Town) to craft substitute language for this portion of Sec. 124. After much negotiation, VAHHS believes Rep. Koch will introduce this amendment on Tuesday. VAHHS has had preliminary discussions with Appropriations Committee Chair Rep. Rich Westman (R-Cambridge) who said he would accept an amendment on this section if the Health and Welfare Committee approved it. VAHHS is already working with the members of the Senate Committee on Appropriations to amend this language.
The language VAHHS submitted last week that added $4.1 million to increase reimbursement rates for hospitals and all other providers and requested VAHHS and PATH continue to work toward developing an efficient and effective payment system for Medicaid services was also included in the budget bill.
Capital Construction CostsThe House Committee on Health and Welfare continued their discussion on capital construction costs and heard testimony from Porter Medical Center and Dartmouth-Hitchcock among others. The committee is scheduled to continue their deliberations this week with testimony from Dave Demers of Fletcher Allen.
Clinical TrialsH.255, a bill to require that health insurance plans pay for routine medical costs for patients enrolled in clinical trials was amended and voted out of the House Health and Welfare Committee after a voluntary proposal was hammered out between providers, insurers and BISHCA.
The bill as originally introduced would have required that insurers pay for routine patient care costs for all phases of approved clinical trials for cancer and other life-threatening illnesses. Since several insurers already pay for routine patient costs, they believe that the bill would simply shift funding of clinical trials away from government and private sources onto health benefits premiums.
The bill as amended authorizes BISHCA to draft rules that implement the voluntary agreement. The plan calls for BCBSVT, MVP, CIGNA and Medicaid to pay for routine patient care costs (cancer trials only) for trials conducted under the auspices of the Vermont Cancer Center at Fletcher Allen Health Care, the Norris Cotton Cancer Center at Dartmouth-Hitchcock, and approved trials being administered by a Vermont hospital and its affiliated providers. The bill also has a sunset at the end of two-years and an analysis of the financial impact of the pilot program will be reported to the legislature by October 1, 2004.
The Governor’s Bipartisan Committee on Health Care Availability & Affordability a.k.a The Hogan CommissionGovernor Dean's appointed health care commission has held two meetings and is gearing up for its study of the state's health care system. A test web site has been set up and will become public soon, and a site has been established for comments and testimony from the public. Those sites are: www.state.vt.us/health/commission/testimony/testimony.htp and www.vdh.state.vt.us/test/
Dean appointed former Human Services Secretary Cornelius Hogan as chair of the committee and also appointed current Human Services Secretary Jane Kitchel and Elizabeth Costle, commissioner of BIHCA. Also on the committee are Sens. Nancy Chard (D-Windham), Cheryl Rivers (D-Windsor), Reps. Tom Koch (R-Barre Town), Frank Mazur (R-South Burlington).
The Governor asked this group to:
- To study data and information relative to increasing health care costs, cost shift and availability of services.
- To talk with employers and others concerned with rising health care costs and access to health care.
- To identify ways we can achieve the dual goals of controlling costs and guaranteeing universal health care access.
- To report back to him and to the Legislature on our findings and to lay out recommended approaches to address these problems.
Coming UpHouse Committee on Health and Welfare – This week the committee will focus on capital construction costs again as well as long term care/nursing homes. Additionally, the committee will begin taking testimony on H.416 relating to health care information. The committee will also spend a portion of Thursday talking about the role of UVM in Vermont health care infrastructure and quality.
House Committee on Appropriations – The committee’s focus this week will to attain the full House’s final approval on H.485, the appropriation bill and finish up the negotiations with the Senate on the Budget Adjustment bill.
Senate Committee on Health & Welfare – The committee will continue their focus on the Medicaid cost shift, outcomes assessments, and prevention and incentives for healthy lifestyles. They will also the clinical trials agreement this week.