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For the week ending April 14, 2006
Political Overview
As we enter the last few weeks of the session, money bills will take center stage now that the Senate has passed the health care reform bill. Over the past week there has also been a noticeable shift from lawmakers working in their respective standing committees to working in conference committees, consisting of three House members and three Senate members, where they hammer out the differences in the House and Senate-passed versions of key bills. In the second year of the biennium there is always the possibility that the session will be held up if one body insists it must have a particular bill before going home.
The Senate gave final approval to a bill that increases the mandatory minimum sentence for aggravated sexual assault to 10 years. The bill also hires more sex crime investigators and expands the sex offender registry program. The bill as passed the House did not include mandatory minimum sentences and instead established an advisory minimum sentence a judge is not bound by. A conference committee will be appointed to work out the differences of the two bills.
VAHHS Issues
Health Care Reform
H. 861
The Senate passed on the floor H. 861 on a vote of 24-3-3. The process was sometimes contentious with both the democrats and republicans caucusing throughout the week. On Monday afternoon, the Senate Health and Welfare Committee met to review H. 861 before final vote of the bill. Minor changes in language were made around coverage and administration of immunization through Catamount health, employer premiums, and administration of the Blueprint for Health. The Committee voted out the bill later in the afternoon where it swiftly moved to Senate Finance.
Senate Finance heard testimony throughout the week on financing mechanisms related to H. 861 on the cigarette taxes, premium and payment rates. The Administration provided feedback on their concerns around the bill including provisions around financial sustainability, enrollment and concerns around
Ken Thorpe, Consultant to the Commission on Health Care Reform, returned mid-week to assist in providing additional explanation and revisions to the bill. He provided overview of the major bill provisions explaining the cost saving mechanisms and including implications on the cost-shift. Dr. Thorpe spent most of the week meeting with the legislature and various stakeholders on the mechanics of the bill in order to gain needed consensus.
H. 861 was debated and passed by the Senate floor Friday. Senator Matt Dunne unsuccessfully sought to amend the bill with a provision that would implement hospital global budgets. This proposal would have limited hospital budgets by the total annual growth of hospital costs to the Consumer Price Index plus three percent. Three amendments supported by VAHHS on (1) including outpatient services in the Medicaid update of 5%, (2) requiring a private entity to offer Catamount Health with the option of bearing risk, (3) protecting hospitals payments under Catamount Health to keep the “cost plus 10%” language, but ensure a minimum of “cost plus 2%” were brought forth with all three amendments passing swiftly on a voice vote.
With the legislature clearly working towards compromise, the bill has picked up momentum and approval across the legislature. At his weekly press conference on Thursday, Governor Douglas remained optimistic about the prospect of reaching a health reform compromise.
The Senate suspended its rules and messaged the bill to the House so the House can take the bill up for immediate action. A conference committee will be appointed early next week to begin to work out the differences between the two bills. The Senate has been talking with the House leadership throughout the process and this will likely expedite the conference committee.
The Administration continues to voice its concerns over certain pieces of the bill and the Governor’s continued threat to veto the bill. While the outcome remains to be seen, pressure presently seems to be building toward a compromise.
S. 310 - Common Sense Initiatives
The House swiftly passed S. 310 on the floor this week with a division vote (84-4) on the third reading. Only minor amendments were made to the House version of the bill including several changes around the community wellness grants, advance directives language and adding a change in appropriations for FY2006 of $1,013,357 instead of $1,325,800 in general funds and $1,079,289 instead of $1,454,200 in Global Commitment funds to the Department of Health for implementation of the Blueprint for Health Chronic Care Initiative.
A conference committee will be appointed early next week to begin working out the differences between the two bills.
H. 890 – An Act Relating to Emergency Management and Public Safety
A joint House Government Operations and Appropriations Committee met Thursday afternoon to review final amendments to the bill. An overview of the Emergency Management Public Hearing in
House Human Services
On Thursday afternoon, the House Human Services committee voted 8-2 to reject the request from Governor Douglas and his Secretary of the Agency of Human Services, Cindy LaWare, to grant an exemption for the Vermont State Hospital Futures project.
After intense two-weeks of considerable discussion, the House Human Services committee soundly rejected the exemption bid. Even the two committee members who voted for it expressed grave reservation, but indicated they did not want to seem unsupportive in terms of the goal of the project. Although the discussion may not have ended, this strong resolution in the key House committee puts a damper on other possible ways in which legislators might try to circumvent the CON rule.