House Republicans have apparently decided it’s time to pay some lip service to the idea of health care reform.
Emphasis on “little.”
Under the very generous headline “House Republicans Develop Alternative to Shumlin’s Payroll Tax Proposal,” VPR’s Bob Kinzel outlines a half-assed Republican idea that would, at best, produce a fraction of the benefits of Shumlin’s plan. At worst, it’d be a huge step backward for health care access in Vermont.
The Governor has proposed a payroll tax of 0.7%, with the proceeds going to shore up Vermont’s embarrassingly low Medicaid reimbursement rate. Since Medicaid services are now indirectly subsidized through higher charges to non-Medicaid payers, increasing the state’s reimbursement rate should lead to lower insurance premiums for everybody else. Shumlin says the net drop in premiums would more than make up for the new tax, and he would task the Green Mountain Care Board with making sure the premiums go down.
Also, the reimbursement system would be, y’know, fairer.
House Minority Leader (and king of the kneejerk conservative response) Don Turner isn’t buying it. Funny thing: he doesn’t argue against the tax itself. Instead, he invokes the long-discredited Domino Theory.
“It seems like a little number, but you’ve opened the door,” Turner says.
So he’s not arguing against the tax, just the imaginary consequences of the tax.
His big idea? The state should ditch Vermont Health Connect and opt for the federal exchange. Turner figgers we could save $20 million, which could go toward raising Medicaid reimbursements. Even by his perfunctory standards, this is awfully lame. Transparent, even.
Three problems (at least).
— His $20 million estimate is contested by administration officials. And, as I understand it, a lot of the money spent on VHC is actually federal money. How much of Turner’s reputed $20 million is actually Vermont’s money?
— Shumlin’s tax plan would raise $90 million annually, enough to close the Medicaid reimbursement gap by half. Turner’s $20 million would accomplish slightly more than Jack Diddly Squat.
— Worst of all, the US Supreme Court is considering a case that could end federal health care subsidies for states that use the federal exchange. Turner doesn’t give a rat’s.
“We understand there may be a potential for Vermonters to lose federal subsidies,” Turner says. “However, 35 other states are in the same boat.”
We’ve cut the number of uninsured Vermonters in half, and Turner’s response? “Ehh, easy come, easy go.”
Also, about one-third of the payroll tax revenue would allow the state to expand Medicaid to 20,000 more Vermonters. There’s nothing like that in Turner’s “plan,” and he couldn’t care less. As Kinzel reports, Turner “says he’s not convinced that this expansion is a good idea.”
I guess he’s fine with tens of thousands of Vermonters having no health insurance. Or at least he’d rather have that, than a small payroll tax hike that would be more than compensated for by lower insurance premiums.