Legislative Politics and Health Care Spending

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(Host) It’s only spring, but commentator Allen Gilbert thinks that this fall’s political campaigns are already underway.

(Gilbert) It’s usually when days turn warm and the big doors of the Statehouse are opened that legislators know that the session should soon be over. This year, however, legislators on both sides of the aisle sense that except for the really essential bills that have to be passed, the session has already ended – and that this year’s political campaigns have begun.

The Republicans won the House two years ago by playing off the “Take Back Vermont” theme, and they want to stay in charge. Howard Dean announced last summer that he wouldn’t run again for governor. Politics have been at a boil ever since.

Politicking for the fall campaigns is taking place beneath the veneer of legislative business. We’ve already seen one powder keg explode – reapportionment. Another flash point is the state budget. House Republicans carved out one of the biggest pieces of the budget – Medicaid health care spending – from the main budget bill. They announced that Medicaid spending needed much more study and reflection. The House leadership knows that there are three ways to address Medicaid spending problems: cut benefits, tighten eligibility, or raise taxes. But they don’t want their party to get blamed for doing any of these things.

A sub-plot to the budget battle is the tobacco tax. Many people think that it should be raised. A higher tax would discourage people from smoking – a good thing, because smoking-related illnesses drive health care costs higher. The Vermont tax is already lower than the tax in neighboring states.

In his budget, the governor recommended deep cuts to health care. But he suggested that boosting the tobacco tax by 67 cents could add much-needed revenue to avoid some of those cuts. House Speaker Walter Freed has been reluctant to discuss the idea. He’s said that if the goal is to stop people from smoking, tobacco sales should be banned altogether.

Freed can’t be serious. And last week the House Appropriations Committee voted a modest increase in the tobacco tax, 36 cents. The extra revenue would save SOME health care cuts, and Republican committee members figure 36 cents isn’t TOO big a jump.

But the real story is how the Appropriations Committee essentially underfunded health care when it separated the Medicaid budget from other state spending. The committee took $10 million that the governor had earmarked for health care, and used it for other programs. So now we’re left with a hole that can only be filled by a higher tobacco tax, rather than balancing health care with other priorities.

Maybe it’s too much to ask that health care issues be viewed as important public policy issues, rather than political ones. After all, this is an election year. So I’m wondering if it wouldn’t be best for our representatives and senators to finish their legislative work as quickly as possible. Then they could start doing what they’ve already begun – campaigning for re-election. It would be a lot more honest.

This is Allen Gilbert.

Allen Gilbert of Worcester is a writer and parent who is active in education issues.

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