Healthcare

Healthcare issues

VPP Officials Quoted in NYT Article on Healthcare

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Alissa Carberry, 24, a child care worker with Type 1 diabetes, said she had insurance with a $1,900 deductible and had to pay 40 percent of costs after that. CreditJacob Hannah for The New York Times

BURLINGTON, Vt. — Just a few years ago, lawmakers in this left-leaning state viewed President Obama’s Affordable Care Act as little more than a pit stop on the road to a far more ambitious goal: single-payer, universal health care for all residents.

Then things unraveled. The online insurance marketplace that Vermont built to enroll people in private coverage under the law had extensive technical failures. The problems soured public and legislative enthusiasm for sweeping health care changes just as Gov. Peter Shumlin needed to build support for his complex single-payer plan. Finally, Mr. Shumlin, a Democrat, shelved the plan in December, citing the high cost to taxpayers. He called the decision “the greatest disappointment of my political life.”

As the United States Supreme Court prepares to rule in a case that could gut a major element of the Affordable Care Act — federal subsidies for low- and middle-income people — Vermont should have little to worry about. Only states that use the federally run insurance marketplace stand to lose subsidies if the court rules against the Obama administration, and Vermont is among the 14 states that fully run their own.

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Gov. Peter Shumlin announced in December that he was shelving a plan to create the nation’s first single-payer health care system.CreditGlenn Russell/The Burlington Free Press, via Associated Press

But even though its residents’ subsidies appear safe for now, Vermont stands as a cautionary tale. Despite an eventual cost of up to $200 million in federal funds, its online marketplace, or exchange, is still not fully functional, while disgust with the system is running deep among residents and lawmakers alike.

Meanwhile, the hopes for a single-payer system, once tantalizingly close, may be lost for years. Under such a system, the government operates onehealth insurance plan for all residents, covering their medical costs instead of having private insurers do it.

“It’s just been a spectacular crash, really,” said State Representative Chris Pearson, a member of Vermont’s Progressive Party. “We’ve gone from this vision of being the first state to achieve universal health care, to limping along and struggling to comply with the Affordable Care Act.”

The bitterness stems partly from the fact that Vermont had some of the biggest elements of the Affordable Care Act in place long before it took effect. Health insurance companies here already could not refuse to cover people, or charge them more, if they had pre-existing medical conditions. The state also already had more generous Medicaid eligibility rules than most, and programs that helped lower-income people pay for private insurance, which made it less expensive for many than the new exchange plans.

To many Vermonters, the new federal law complicated a state system that had already provided good coverage and muddied the route to an even better model.

“This law, by preserving the private insurance system and treating health care as a commodity, made us do things that Vermont otherwise wouldn’t have done,” said James Haslam, the executive director of the Vermont Workers Center, a grass-roots group that has made universal, government-financed health care its central cause.

To strengthen support for such a system, the workers center is dispatching volunteers like Alissa Carberry, 24, to talk about their disappointment with the Affordable Care Act and why the state should not give up on its single-payer dream.

Continue reading the main story

The Health Care Supreme Court Case: Who Would Be Affected?

If the court rules against the Obama administration, millions of Americans could lose their health insurance subsidies.

 OPEN GRAPHIC

Ms. Carberry, a child care worker with Type 1 diabetes who earns $30,000 a year, said the insurance that her employer provided last year, from Vermont Health Connect, had a $1,900 deductible. Even after she met the deductible, she said, she still had to pay 40 percent of the cost of supplies like an insulin pump. She dropped the plan this year and switched to her partner’s insurance, which is less expensive but still onerous.

“Let’s continue to work for something better,” Ms. Carberry said.

Under the single-payer law that the Vermont Legislature passed in 2011, the state was to seek a waiver in 2017 to trade its insurance exchange for the government-run system. Most of its 625,000 residents would be eligible for a uniform package of benefits under that system, which would be financed with a mix of state and federal funds.

But Mr. Shumlin and his advisers concluded the plan would require “enormous” new taxes, including an 11.5 percent payroll tax on all Vermont businesses and a sliding-scale income tax of up to 9.5 percent. In all, he said when he announced that he was shelving it, the plan would require about $2.5 billion in additional revenue in its first year, in a state that raises only about $2.7 billion in taxes annually.

Many Vermont health care advocates say support for the governor’s plan was also seriously eroded by dysfunction in the state online insurance marketplace. Problems with that exchange had “hurt, there’s no doubt,” public confidence in the effort to achieve single-payer universal coverage, Mr. Haslam said.

Other state-based exchanges have experienced as much or more turmoil: Oregon and Nevada essentially shut down their marketplaces last year, requiring residents who want subsidized insurance to enroll instead through the federal marketplace, HealthCare.gov. Hawaii is also planning to switch to the federal exchange this fall, at least temporarily, after running out of money. Massachusetts was forced to rebuild its exchange last year after it failed to function, and has spent more than $250 million, mostly in federal funds, on it so far.

A number of state-based exchanges, after receiving a total of nearly $5 billion in federal establishment grants, are also encountering financial problems because they now must cover their own costs.

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Trinka Kerr, chief health care advocate at Vermont Legal Aid, a Burlington-based group that fields hundreds of calls per month from people having trouble with the state’s insurances exchange.CreditJacob Hannah for The New York Times

But Vermont, with its initial view of the Affordable Care Act as a bridge to a single-payer system, is in a singularly unhappy position.

“There’s a backlash against all things health care reform because Vermont Health Connect has been such a bad experience,” said Trinka Kerr, the chief health care advocate at Vermont Legal Aid, which gets several hundred calls a month from people who have encountered problems with the exchange, including billing errors and even delayed access to care. “Sometimes they’ll say, ‘I’ll just go without insurance,’ and we try to convince them that’s not a good plan. They don’t like the way this is working and want to go back to the old way.”

Rob Muessel, a self-employed security consultant from Shelburne, is one of those people. He said he spent hours on the phone with Vermont Health Connect representatives over the past year, trying to resolve problems. Most recently, when his daughter got a job with benefits in March, he called the marketplace to get her taken off his plan. Six weeks passed before he got a call back from an exchange employee, who had to spend more than two hours helping him redo his entire application for what should have been a simple fix.

“That just blew my mind,” said Mr. Muessel, 61. “I think it’s time to pull the plug, because it may just be an unending money pit.”

In a blistering report released in April, Douglas Hoffer, the state auditor, detailed a number of unresolved problems with Vermont Health Connect and said it would be “prudent” to develop a plan for “an alternative model for running an exchange.”

Mr. Shumlin had set a deadline of May 31 for Optum, the second vendor hired to fix a problem that has prevented thousands of Vermonters from easily changing basic information in their account, such as if they have a baby, get married or move. Workers have had to process such changes by hand, costing the state extra money and creating a backlog of 10,000 change requests. On Monday, Mr. Shumlin announced that Optum had fixed the problem, allowing such changes to be made in a matter of minutes, although customers will not be able to do so without assistance until later this year.

Optum has a second deadline, in October, to automate the process by which exchange plans are renewed from year to year. In an interview, Lawrence Miller, the state’s chief of health care reform, said the state was analyzing the costs of various alternatives, including switching to the federal marketplace, should the exchange still be broken in the fall.

Mr. Miller said he would prefer Vermont to be “tucked away in a fully state-operated marketplace until we see exactly how the Supreme Court rules” in the subsidies case. A great deal of uncertainty remains about whether people would be able to keep their subsidies if the state started relying on the federal marketplace.

Mr. Miller added that Vermont intends to remain a leader in health care reform, particularly with a plan to replace the traditional system of paying health care providers for each procedure with one that pays them based on outcomes, including under Medicaid and Medicare as well as private coverage.

Pointing out that Vermont’s was not the only state-based exchange to still be struggling, he added, “I talk to my colleagues elsewhere and, good God, this just wasn’t set up for success.”

Progressive Legislative Roundup

Aptil 18, 2014; Bob Kinzel; VPR

Click here to listen!

When the 2014 legislative session started, leaders in the Progressive Party were expressing concern with some of the policies of Governor Shumlin. How do they feel about the Governor now as the session winds down?

We’ll talk with the House Progressive Caucus leader, Burlington Representative Chris Pearson, and with Enosburg Representative Cindy Weed and Senator David Zuckerman about the progressive legislative priorities for the end of the session.

Read the original article >>

Could Vermont change the healthcare game?

Click here to watch on MSNBC.com

From MSNBC's UP With Steve Kornacki: "Could Vermont’s single-payer health care experiment be a game changer? Vermont State Rep. Chris Pearson joins the UP panel to discuss."

Watch on MSNBC.com >>

As Vermont Goes, So Goes the Nation?

April 5, 2014; Molly Worthen; New York Times

"Three years ago, Peter Shumlin, the governor of Vermont, signed a bill creating Green Mountain Care: a single-payer system in which, if all goes according to plan, the state will regulate doctors’ fees and cover Vermonters’ medical bills. Mr. Shumlin is a Democrat, and the bill’s passage is a credit to his party. Yet a small upstart spent years building support for reform and nudging the Democrats left: the Vermont Progressive Party. The Progressives owe much of their success to the oddities of Vermont politics. But their example offers hope that the most frustrating dimensions of our political culture can change, despite obstacles with deep roots in American history."

Read the whole article >>

Minutes - February 2014 State Committee Meeting

February 8, 2014; 1:00 pm, 
North End Studios, Burlington
In attendance: Approximately 60 people attended, with another several guest speakers.

Welcome: Emma Mulvaney-Stanak
Emma opened the meeting and thanked everyone for attending. She offered up an instant poll for State Committee members to answer a survey question on paper or electronic meeting materials. Those State Committee members without smartphones participated by a raising of hands. Most people indicated a preference to receive materials only electronically. Party leaders will take this into consideration when planning future meetings. Emma also asked people to support the party by becoming a monthly or one-time donor.

Panel: Burlington City Council Update and City Committee Leaders
All four incumbent Progressive City Councilors shared highlights on issues they are working on ranging from climate change initiatives to public safety to transportation (bike/ped issues) to updates on Burlington Telecom. Councilors Max Tracy and Rachel Siegel are up for reelection this March. Max needs help with his council race – volunteer support and financial support – because he is running against a well organized Democrat. Rachel has an opponent, but does not expect a tough race. Councilors Vince Brennan and Jane Knodell are up for reelection in 2015. There is an open seat for City Council in Ward 1 and State Party Vice Chair Selene Colburn is running unopposed for that seat. We expect to have 5 city councilors out of 14 after Town Meeting Day. Democrats currently have 7 seats with a possibility of gaining one more seat. The other two seats are held by Independents. Burlington City Chair Kyle Sillman-Smith and Vice Chair Ali Zipparo shared ways they have reenergized their city committee including regular informal “breakfast club” gatherings, leader recruitment to get more people involved by creating a database of potential leaders to draw from when commissions and boards have openings in the city, and a regular city committee meeting schedule.

Paid Sick Days (PSD) Panel
We were joined by Rep. Cindy Weed, Lindsay DesLauriers from Voices for Vermont’s Children, Cary Brown from the VT Commission on Women, Cecile Reuge from the VT Workers’ Center, and Dan Barlow from VT Businesses for Social Responsibility. Rep. Weed gave an overview of the Paid Sick Days bill in the House and explained it is due for a vote in her committee (House General) next week and could be voted on by the full House as early as mid February. The fight will be whether or not carve outs get added to the bill before it leaves committee. Also the Senate is not as supportive of the bill and the Governor is not a guaranteed supporter either. Lindsay explained the PSD issue from the angle of families/children and gave an overview of PSD history in VT. Cary explained PSD as an issue that relates disproportionately to women because they tend to hold more low-wage, service/retail jobs in VT that tend to not include paid sick leave. She also raised the issue of victims of domestic violence and the challenge of taking leave to heal from acts of violence. Dan explained the business angle and impact on the economy and noted several businesses are supportive of this bill, but several are speaking out and starting to pressure Representatives not to support this bill because it is an added “burden” on businesses. Cecile explained the VWC’s organizing effort to get PSD passed this session and ways people could help.

Emma then asked SC members to take action at the meeting and contact their state representative, senator and the Governor’s office to ask them to support the PSD bill. Legislator contact information was shared and people took time to place calls. We reviewed a list of key legislators who would benefit from being contacted. VPP will send an email action alert to share that list and ask all VPP members to take action on this bill early next week.

Break/Raffle Drawing

Regional Breakouts
The SC membership broke into regional groups to discuss local issues and potential house and senate districts for the VPP to target in the 2014 election cycle. Based on limited numbers from certain parts of the state, we had groups meet together from the Northwest region (Franklin, Grand Isle, Lamoille Counties), Chittenden/A-R (Chittenden, Addison and Rutland Counties), NEK/Central Vermont, and Southern Vermont.  CoCo members from each region facilitated the conversation. SC members said this was a useful way to break up the meeting. Party leaders will try to find ways to keep conversations going on topics raised in between SC meetings.

Platform Review Committee Update
Ben Eastwood (Montpelier) reported as Chair of the new Platform Review Committee. There is no written procedure on how to set up the process for reviewing the platform beyond formal ways to adopt changes to the platform (state law and VPP bylaws). The CoCo endorsed a process for this round in January. The committee will be appointed by the State Party Chair and limited to 5 members to keep it workable. An attempt will be made to achieve geographic diversity and a mix of new and experienced voices. The committee will also be charged with offering a written recommendation on a procedure to adopt for future platform review work so the Party has a known process going forward. The Chair appointed: Ben Eastwood (Montpelier, Chair of Montpelier Town Committee and Washington County) as Chair, Leslie Matthews (Northfield, former Coco member, SC member), Tim Kipp (Bratteboro, SC member), Cindy Weed (Enosburg Falls, former chair of platform committee last time, State Rep), and Becky Raymond (Middlesex, new Party member). Becky recently resigned from committee, so the Chair will work to fill the vacancy. The committee also has a recent UVM grad working as an intern for the committee.

The process is still being created, but it will include several ways to engage SC members and other Party members in reviewing and offering feedback on the platform. It will also include a very clear set of procedures, including any amendments and the process for voting/debate ahead of the September SC meeting where the SC and town and county chairs will be asked to adopt/reject any changes. The May 31st SC meeting will include a large portion of time on the agenda for platform discussion and input. The committee hopes to have any proposed amendments ready for the CoCo to review in mid July. Questions and feedback can be sent to Ben.

Party Committee Reports
Corey Decker (Enosburg) reported as Chair of the elections committee. Emma reported for Chairs who were absent from the meeting, including Chris Brimmer (organizational development committee), Martha Abbott (fundraising committee), and the communications committee (who are in need of a new Chair). All committees are looking for volunteers. Here is a description of each committee’s charge:

Fundraising Committee
Committee will develop an annual fundraising plan for the Party, oversee fundraising appeals to Party members (initial ask, follow up ask, etc.), revamp fundraising strategies used by the Party in the past, assist staff with development of appeals (letters, online, etc.), assist staff with organizing fundraising events (small), train Coco members and other Party leaders on how to effectively fundraise, and plan an annual major fundraising event for the Party.

Elections Committee
Committee will develop and conduct campaign trainings for candidates, campaign managers, and campaign volunteers during the 2014 election cycle (build capacity of party to run strong campaigns). The committee will also assist Party leaders and staff in recruiting candidates to run in the 2014 election cycle and assist the CoCo and State Committee in any Party endorsement process for the 2014 election. The committee will also support Burlington City Council campaigns as necessary (Jan-March 2014).

Communications Committee
Committee will develop a communications strategy for the Party, assist staff with press releases for the Party, assist staff with social media and blog postings, review the website for relevant content, and help advance the 2014 special project - corporate campaign donations petition. The committee will also help staff and the CoCo work on branding and promoting the party on a statewide level (messaging).

Organizational Development Committee
Committee will assist CoCo in doing quarterly outreach (to increase attendance) to the state committee members for quarterly meetings, develop "on-ramp" events for new Party members to get involved in Party outside state committee meetings, and examine more ways for the Party to involve new members (on the ground engagement and promotion of Party). The committee will also work with Chair ahead of state committee meetings to develop state committee agenda items that will spark engagement by members (and ideally attendance!).

Legislative Update
Rep. Chris Pearson and Rep. Cindy Weed gave a brief update from the Legislature. The conversation focused mainly on the health care policy debate and the road to single payer (or not) based on the roll out of the state exchange and new rules facing Vermonters without health insurance and employers who do not currently offer insurance.

Submitted by Chris Brimmer, Secretary 2/20/14

Paid Sick Days are a Vermont Value

We, in each of our towns, and throughout The Valley are, together, a community.  As Town Meeting approaches, I trust that all of us, regardless of our particular political persuasions, agree.  And as a community we do right to concur that one does well, when one’s neighbor does well.  This commitment to our friends, family, and fellow residents is an old one. When the Green Mountain Boys evicted New York land surveyors, tax collectors, and sheriffs, I do not doubt that they too were motivated by this notion of self-preservation as inalienably linked to community; Freedom and Unity. More recently, we saw this belief manifest during the crisis following Irene. Two and one half years ago I was honored to see many of you from Waitsfield, Warren, Duxbury, Fayston, and beyond coming to lend a hand in Moretown during our hour of need.  Such acts of human camaraderie will never be forgotten.  In essence Vermont has a long and proud history of people reaching out in solidarity when their neighbors could use a hand.  We are, in a word, a people who embrace and honor the core value associated with the very notion of community as the foundation upon which rests the prosperity of the individual.

Today, we can and do express our sense of community, not only in time of crisis, but also through a maturing social compact which gives form to the worth and well-being of our fellow citizens.  Maintaining and improving an equitable education system that gives support to children and families is one such expression.  Creating a Vermont controlled healthcare system that provides insurance and quality medical care regardless of job or lot in life is also such an expression. Guaranteeing that all working Vermonters are afforded the right to accrue paid sick days is yet another.

It is for these reasons that I support H208, a bill currently in the Vermont House of Representatives that would guarantee all Vermonters the right to earn up to 7 sick days in a given year. As your neighbor, I encourage you to support this noble effort too.

The fact is, all people get sick some time or other; most of us a few times a year.  When this happens, when one has a fever, one should be able to stay home for a day and get better.  And if your kid is home sick, and if both parents have to work, one parent should be afforded the economic ability to care for the child during that time of need. How could one begin to construct a moral argument against this statement?  Either we are a community, and therefore embody the core truth inherent in the principle which is Vermont, or we are not. I assert that we are Vermonters.

However, the reality is that thousands of low income people in these Green Hills do not have any paid sick days. When they get sick, they often must make a hard decision: work while their body and mind are turned against them, or stay home and miss one fifth of their weekly pay. For the many, this one few-and-far-between unpaid sick day means the phone will be shut off; the rent will be late; the kids will miss a meal. For those that do work when they are ill, not only does their productivity go down, but they typically infect their co-workers which, in turn, makes productivity sink measurably lower.  Therefore, as a community and as Vermonters, it is absurd to maintain a status quo which serves no human, neighborly, or long-term interest. For these and other reasons, H208 (paid sick days) is supported by both Vermont Businesses for Social Responsibility and Organized Labor. 

As a resident of Moretown, as part of the broader Valley community, I encourage all of you to take a moment to reflect on this human issue.  I encourage you to express your support for H208.  I also encourage our two State Representatives, Maxine Grad and Adam Greshin to actively support this bill with no exemptions. I also call upon our Governor and Washington County Senate delegation to likewise support this legislation. By doing so, they will all be casting a vote in favor of the Valley’s working families and in line with Vermont’s long tradition of valuing our community over short term and private interests. After all, one does well, when one’s neighbor does well.

David Van Deusen is Chair of the Moretown Progressivt Comittee. He is also the elected 1st Constable of Moretown, is a former Selectboard Member, and currently works for the Vermont State Employees Association as a Union Representative responsible for Central Vermont.

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