Health Care Bill Clears Final Hurdle; Question Now Is How To Pay For It

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(Host) Legislation that’s designed to move Vermont to a publicly financed health care system won final approval in the House this afternoon and the bill is now on its way to the Governor for his signature.       

But the proposal doesn’t answer a question that many people in the Statehouse have – and that’s how to pay for a single payer system.  

That decision has been put off until 2013. But as VPR’s Bob Kinzel reports, Governor Peter Shumlin has some ideas about how the system could be financed.

(Roll Call) "Please listen to the results of your vote. Those voting yes 94 those voting no 49 and you have adopted the committee of conference report on H202.

(Kinzel)With those words, House Speaker Shap Smith completed the legislative journey for a bill that backers hope will totally transform the state’s health care system. 

It establishes a consumer insurance exchange and it creates a new 5 person Board that will oversee virtually every aspect of health care in the state.

House Health Care chairman Mark Larson said the bill is needed because the state’s current health care system is broken:

(Larson) "Despite all of our state’s healthcare reform efforts for which we are a national leader too many Vermonters continue to be uninsured and even more face financial risk if they get sick or hurt because of inadequate insurance."

(Kinzel) The decision about how to pay for a publicly financed system is delayed until 2013.  Franklin senator Randy Brock tried unsuccessfully to move this date up to 2012 because it’s an election year.

(Brock) "I think in particular it’s also critical to get validation from the public as to whether or not what we’re doing makes sense.  And the best validation of that is at the ballot box."

(Kinzel) A number of lawmakers think imposing a payroll tax on employers and employees is the best way to fund a publicly financed system.

Washington senator Anthony Pollina is a long time supporter of a single payer system. He said it’s too early in the process to rule out using the income tax as a way to capture revenue from people with a lot of unearned income.

(Pollina) "I would also just like to take issue with one of the statements that was made which seemed to imply that we’re tied into a payroll tax to fund this and it’s just not something that I’m prepared to tie myself into."

(Kinzel) The governor isn’t tipping his hand about using a payroll tax and /or an income tax.  But he says he supports an approach that links a person’s deductible and co-payment to their income. The higher the income – the higher the co-payment for non primary care procedures.

(Shumlin) "I actually believe that everyone should have some skin in the game based on their ability to pay when you pay medical bills. Not for preventative care but for other care."

(Kinzel) And Shumlin is convinced that such a system could be implemented without a lot of administrative paperwork.

(Shumlin) "Most systems in the world other than America base some of the co-payment as we call it on your ability to pay and that’s worked well for the other countries we should look at that."

(Kinzel) The new Health Care Board will recommend a financing plan for lawmakers to consider in January of 2013.

For VPR News, I’m Bob Kinzel in Montpelier.

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