Governor, Lawmakers Debate Health Care Costs

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A year ago, Governor Howard Dean named a bipartisan commission to study a range of health care issues in Vermont. The commission wrapped up its work last month and some of its suggestions will be before the Legislature this winter.

But there’s little agreement on what steps the Legislature should take to implement health care reform.

VPR’s John Dillon reports.

Health care may emerge as one of the most difficult issues of the 2002 legislature. Health insurance costs have risen 20% over the last year. That’s a level most businesses say is unsustainable.

Meanwhile, the state budget is in a deficit. So there’s no money to spend on expanding state programs that cover people without health insurance.

On Tuesday, Governor Howard Dean vowed that no child will be cut from state health care rolls. And he said he wants to expand health coverage by allowing small businesses to buy into the state health access plan. This program – known as V-HAP – provides insurance under the umbrella of the Medicaid system.

Thomas Koch is a Barre Town Republican who chairs the House Health and Welfare Committee. He’s leery of allowing business to buy into the VHAP. Koch says Dean’s plan will allow the state to compete with private insurance companies.

(Koch) “It narrows an already small insurance pool. I don’t think it’s cost-free as it’s being billed to the state. And what it really does is build on a Medicaid system that’s already in trouble. That’s going to be the big issue of the year. What are we going to do generally about Medicaid? I think Medicaid has to be reformed. And rather than adding onto an already shaky system, I think we need to take a look at how to reform it.”

Koch says when he talks about Medicaid reform he’s means changes in benefits and eligibility guidelines for Medicaid. He says he won’t recommend cutting children off V-HAP or Medicaid.

Governor Dean also wants to add teeth to the hospital budget approval process. He says hospital budget reviews should be linked to the state review of new hospital construction plans. He says that’s essential to control the skyrocketing cost of health care.

Senator Nancy Chard is a Windham County Democrat who chairs the Senate Health and Welfare Committee. She supports Dean’s proposal on hospital budgets.

(Chard) “That’s an extremely important statement he made yesterday and I support a dramatic revision of the CON process and the Health and Welfare Committee is beginning on that process. Certainly we have ¿no record of performance from hospitals in terms of cost containment. Hospitals get a budget approved and then spend from resources that weren’t identified in that process of review.”

Koch, who is Chard’s counterpart in the House, questions Dean’s plan. He says it would amount to setting an overall cap on hospital budgets. He says that’s “top down” regulation that probably won’t work.

He says the real issue is the cost of the state’s Medicaid program. He says it faces a $27 million deficit in fiscal year 2003.

For Vermont Public Radio, I’m John Dillon in Montpelier.

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