Here’s the topline for today’s developments re: funding for improvements to Vermont’s health care system:
That’s the target figure for new revenue agreed upon by key House leaders. A big comedown from the House Health Care Committee’s $52 million, but enough to make some progress in closing the Medicaid gap*, enhancing access for the working poor, and trying to attract more primary care providers.
*The gap closure is likely to favor primary care doctors, since they’re the front line of health care and also the most financially precarious.
Exactly how the House will get to $20 million is unclear. House Ways and Means is aiming to pass a bill this week*, but it would then face an uncertain fate in the Appropriations Committee. And the House floor. And the Senate.
*Committee vote today postponed due to the absences of two Democratic members.
But $20 million seems etched in stone, at least in the House. So this morning, Ways and Means examined five different tax packages that would raise roughly $20 million per year. The options include: some sort of tax on sugar-sweetened AND diet beverages, removing the sales tax exemptions on candy, sweetened beverages, imposing the rooms and meals tax on vending machiens, increasing taxes on cigarettes and/or tobacco products, and my fave: imposing the sales tax on dietary supplements.
Gasp! Yes, lawmakers might force us to pay sales tax on cranberry extract pills, antioxidants, probiotics, pro-oxidants (is that a thing?), and all those other sundry preparations clogging the shelves of your local food co-op.
I am now counting down to the arrival of the Bee Pollen Brigade with cries of outrage. This could be the next mass invasion of the Statehouse.
But it’s among the least unpalatable options before Ways and Means. As of this writing, there’s no sense of a committee consensus or even a majority behind any of the five tax packages. (Conservative Democrat Jim Condon tried a Hail Mary pass this morning; he floated the idea of selling bonds to pay for some health care reforms. The idea was quickly shot down by the Treasurer’s office, which pointed out that it’s considered improvident to bond for short-term spending. Or, to put it in Treasurer’s terms, “You should make sure the useful life of the asset is at least as long as the life of the bond.”)
Ways and Means is working from five proposed tax packages; all five are outlined, with revenue estimates, on the committee’s website.
So, the details of the revenue package remain unclear, but the bottom line is not.
$20 million for health care.