Legislative Update

Rep. Anne B. Donahue

March 29, 2008

When the budget bill reaches the House floor — as it does this week — it signals the start of the countdown to adjournment. The Senate will review the work of the House during the month ahead, a conference committee of six members will work out the differences, and other bills not yet passed at that time will die for this biennium.

This year’s health care reform update bill and the pay act will also be before us, and we will return to an interrupted discussion on “riparian buffers.”

The riparian buffer bill took an abrupt detour on the floor last week after some challenges began to take their toll.

In my opinion, at its core, this is a good and important bill.

I told colleagues on the floor that after being born in Vermont, I always longed to come back. One of our cherished assets, of course, is our crystal clear streams and rivers. One of the first things I did when I arrived in Northfield in 1990 was to find our best swimming hole.

I was stunned to later learn that many of the “crystal clear” waterways of our state are polluted. These are a public trust of the state, and I believe that unlike other state meddling, protecting and restoring them really is a state obligation.

The bill sets a standard of a 50 foot “buffer zone” along the banks of lakes and streams — a zone where plantings can absorb the pollutants that otherwise will run off into the water.

It has excellent protection for existing uses and for home rule for local communities to supercede the state law when it make sense for issues that need to be addressed locally.

Unfortunately, there was a stunning confusion unearthed during debate. As written, the bill would cover any water that flowed year around, even a brook you can step across. That’s a whole lot of land taken up in one swell swoop for buffers — to say nothing of enforcement costs!

That was apparently not the intent. Depending upon who spoke when, it was intended to cover only waterways about 50 feet or wider, or only rivers of the “fourth degree” or larger (each degree represents the merger of two lower degree streams.) The bill was thus suspended from floor action midway through the second day’s debate.

The budget bill for fiscal year 08-09 upholds, for the most part, the commitment to not increase any taxes in this time of economic uncertainty. It does set different priorities from the budget the governor sent to the House, and had to fill some holes from unrealistic figures from the administration.

We won’t be supporting a lease of the state’s lottery as a fund raiser. Our appropriations committee, however, could only find money to restore about $5 million of the $16 million surcharge on hospitals that the governor proposed.

The House leadership is, however, playing its own games of hidden taxes by shifting costs.

Most significant of these come in the continuation of health care “reform.” Two years ago, I said that the new “Catamount Health” state-subsidized insurance plan should be named the “Medicaid Bankruptcy Act of 2006.”

Unless you know that funding is sustainable — and the was no evidence Catamount would be — there should not be promises made that cannot be kept. Our first promise is to our lowest income Vermonters; our second effort should be on changes that make it possible for all premiums to slow their skyrocketing increases.

We knew in 2006 that it was a big gamble as to whether the federal government would agree to share in the cost of a Medicaid-like program for a next-higher income bracket. We lost that gamble, and Catamount is now requiring a large general fund subsidy.

Half of the 10 percent or so in Vermont who are uninsured are eligible for regular Medicaid but not signed up. Part of the 2006 reform bill was to lower premiums to make it more affordable for them. This year — with the added burden of Catamount — we need to to make the counter-productive move of raising premiums for both programs.

And while legislative leadership talks about fighting the cost shift, two new initiatives will increase the amounts we pay as a result of costs that end up in our premiums when we tax parts of the health system in ways that will merely make their way back to us (with administrative cost added on.)

First is the new private insurance mandate to cover young adult children and divorced spouses. Both these groups can already access coverage through Catamount. This is an attempt to shift something that was already budgeted in Catamount back to the private market. (The same private market that we critique for its added cost overhead.)

This move actually takes away from access to coverage for some people, although it will be promoted as a “new” protection in a year when hoped-for expansions to Catamount for small businesses were forced aside by cost.

There is a much larger cost shift that will hit your premium pocket as an add-on through at least the next ten years. We are planning to pay for doctors to put electronic medical record technology in their offices.

Studies have shown that under a revolving loan fund, such technology can pay itself back quickly. Our health care committee apparently spoke with a random sample of doctors who said they weren’t interested in doing that. So now we are going to give IT systems away through a tax on insurers, to the starting tune of $33 million.

Keep in mind that providers that have already paid for systems, such as the Central Vermont Medical Center’s initiative, loose out.

Although there has been a lot of talk about the cost savings that may ultimately result for all of health care, the studies being cited are actually quite equivocal. Any benefit that results goes to everyone, but only those paying private premiums will be contributing.

Premiums are not a progressive form of taxation. Higher wage earners usually have better benefit packages. It is one of the clearest reasons that our current, employment-based insurance system is no longer the way we should be funding health care, but we’re not improving the situation in Vermont right now.

As much as I support our citizen legislature, it has the drawback of a short institutional memory, and the difficulty of staying on a consistent track.

Just look at the Vermont State Hospital: five years after becoming decertified and sued by the federal government for violating our citizens’ rights to safe care, we will end this session with little progress on replacement programs. Shame on us.

Most frustrating — perhaps most egregious — is the way we continue to merge major policy bills into the general budget, essentially cutting off focused debate on these issues.

Last week, the information technology bill was folded into the budget. Opponents of this new health care tax, such as myself, will have to fight it by introducing an amendment to strip it from the budget, a more complicated way to inject a discussion into a much broader bill.

I will be making such an amendment this week. Curbing health care cost growth is too important to ignore. But once again, we’re using the process backwards.

Please let me know about the issues important to you as we come into the home stretch of this session. I am committed to your interests, particularly in focusing on the high tax burdens we all face. Leave a message any time at counterp@tds.net, 485-6431, or the statehouse, 828-2228, and I will get back to you as soon as I am able.