What would S.252 do? Update on the Senate’s attempt to water down Act 48, our universal healthcare law
In 2011 Vermont’s legislature enacted Act 48, the healthcare reform law that set us on the course to have universal, publicly financed healthcare by 2017. Many of us were involved in the grassroots organizing that was instrumental in bringing about this landmark legislation that requires our new healthcare system, Green Mountain Care, to adhere to human rights principles.
On March 28, the Senate passed a bill (S.252) which, if adopted by the House and enacted into law by the full legislature, will erode key provisions of Act 48 and risk violating the principles of universality, equity, and participation. The main problems with S.252 are:
What Healthcare We’ll Get
Act 48 sets a floor for “benefits” and leaves it to the Green Mountain Care Board to recommend, with public input, what health services GMC will provide. But S.252 turns GMC into an insurance plan with limited benefits. It says that GMC will have the same benefits as the “benchmark plan” offered by Blue Cross Blue Shield on Vermont Health Connect. This excludes dental, vision, and long-term care. By determining GMC’s actual benefits -- rather than a benefit floor -- S.252 not only eliminates these needed services but also takes this decision out of the out of the hands of the Green Mountain Care Board and the public participation process.
Whether There’ll Be Barriers to Care
Act 48 says there must be no barriers to accessing care. User fees, also called “cost-sharing,” can pose barriers to access. Act 48 asks the Green Mountain Care Board to consider whether to impose cost-sharing, such as co-pays and deductibles, based on how this would impact access to care. S.252 appears to curtail this process by saying that GMC will be the same as the “benchmark plan” in the exchange, which does have cost-sharing -- all plans in Vermont Health Connect do.
Who Will Be Included
Act 48 says that all Vermont residents are included in Green Mountain Care. This makes it a truly universal healthcare system. People with TRICARE or the Federal Employees Health Benefits Program would get Green Mountain Care if their insurance benefits fall short. But S. 252 excludes these groups from Green Mountain Care and instead places the burden on them to opt-in, and it also requests a study that could lead to Medicare recipients being excluded. This is a violation of the universality principle.
Act 48 requires Green Mountain Care to provide comprehensive care as a public good for all. S.252 is trying to change this and throw us off course from our path to universal care. It will undermine our human right to healthcare if we don’t take action now.
We can take action to stop this attempt to deny us the healthcare we need! The House Health Care Committee is now looking at the Senate bill and will be able to amend it. Rep. Kristy Spengler and others introduced a bill, H.776, that addresses many of these concerns. H.776:
- raises the floor for “benefits” to ensure that everyone’s access to care will be better
- requires that we all get the care we need, including dental and vision
- eliminates premiums and all user fees, such as co-pays and deductibles
- requires equitable financing, so that individuals and businesses contribute according to their abilities