Category Archives: Health care reform

Here’s a pleasant surprise

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I didn’t think the Governor had it in him, especially in the wake of his Election Night smackdown. But he’s not giving in to the Pitchfork Brigade’s call for the head of Jonathan Gruber. Neal Goswami of the Mitchell Family Organ:

Vermont Gov. Peter Shumlin said Monday that a state contractor under fire for derisive comments he has made about American voters and a Vermont commentator will not have his state contract terminated despite calls to do so by Republicans.

Jonathan Gruber, a Massachusetts Institute of Technology economist, has a personal services contract with Vermont that will pay him up to $400,000 to test economic models related to Shumlin’s universal, publicly-financed health care proposal, often referred to as a single payer system.

The Governor’s stand does come with strings: He will not exercise an option to extend Gruber’s contract beyond its expiration in Februiary. And he did his best to dump all over the contrator whose economic model is too valuable to do without:

…”for me it’s not just what he said, it’s that he actually thinks this stuff. It’s not the way we do things in Vermont.”

Shumlin was also careful to delineate between Gruber the technocrat and Gruber the policy advisor:

“It’s our plan, not his. It’s our policy, it’s our hope for the future and it’s our plan. We’ve used him as a calculator not a policy advisor,” Shumlin said.

Okay, fair enough. Keep him on, and do what you must to distance yourself from his arrogance. Much better than to give in to the howling mob.

Grubermania: Catch it!

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Well, Vermont conservatives finally have a live one: a get-your-blood-boiling, wave-the-bloody-shirt phony “issue” of the kind that rarely presents itself in our green and pleasant land. And boy howdy, are they ever jumping on the outrage train.

Critics of the Shumlin administration are demanding the dismissal of a state consultant whose remarks about the Affordable Care Act last week went viral on Twitter and was picked up by major news outlets…

The target, of course, is Jonathan Gruber, health care expert and creator of the best economic model for health care systems. And utterer of some completely charmless comments on a handful of occasions over the past few years.

Just think, in this age of digital media, how many Young Conservatives are being gainfully employed searching through endless hours of Gruber’s public appearances, trying to locate bits of marketable outrage. Gruber’s been a high-profile figure in health care reform for many years; because of the unique usefulness of his model, he’s been hired by the feds and a whole bunch of states. He’s given testimony, he’s given speeches, he’s been on countless panels.

But never mind the inherent unfairness of tearing a man’s reputation to shreds over a few words. We’ve got some rabble-rousing to do! And our junior-league rabble-rousers are in full force: Rob Roper, Darcie Johnston*, and oh wait — here’s a new entrant to the Pitchfork Brigade: the previously cool-headed, plausibly nonpartisan Campaign for Vermont!

*And again I say, why in hell is anybody listening to Darcie Johnston after the faceplant of the Dan Feliciano campaign added another chapter to her Little Book of Failure?

Between this and CFV moneybags Bruce Lisman’s recent mouth-foamer of an opinion piece (about which more in an upcoming post), it looks like CFV is finally shedding its chrysalis of nonpartisanship and emerging as the Butterfly of Fiscal Conservatism we all suspected was in there all along.

All this Grubermania has a purpose: to toss a can of nails in the Road to Single-Payer, as VTDigger’s Anne Galloway reports:

Gov. Peter Shumlin… is moving ahead with his signature single payer health care initiative. Gruber’s work is crucial to that effort.

“Crucial” because Shumlin has to show that single-payer won’t hurt the state’s economy. Gruber’s model is by far the best tool for the job.

No Gruber, no model. And Shumlin’s task gets a little bit harder.

Now let’s see what kind of cojones the Administration has. WIll they stand by their guy in the face of grossly exaggerated attacks? Or will they toss him off the dogsled in hopes of distracting the wolves?

Based on past experience, I hope Gruber is packin’ a Bowie knife. After all, one of the great saints of Vermont liberalism, Peter Welch, fell for a similar outrage over alleged malfeasance at ACORN. Welch, you may recall, played a small and ignominious role in ACORN’s termination. Sadly, I expect nothing better of Governor Shumlin.

Time to change the subject

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Huh. Day One of Vermont Health Connect 2.0 passed uneventfully, the website performing as expected with only “minor issues” that were resolved immediately.

“It was a nice, boring morning,” [chief of health care reform Lawrence] Miller said. “And that’s what we look for.”

Cool beans.

Of course, unlike last year, the site wasn’t overwhelmed by hordes of eager applicants. According to the Mitchell Family Organ, the site processed 80 new applications and 401 renewals. A nice number, but not a flood. And, we should note, some of the website’s functions are off line until after the open enrollment period ends.

So, baby steps. But so far, so good.

And as long as things are going well, we can safely ignore Republicans’ call to tear the whole thing down and join the federal exchange, complete with its lower subsidies and possible dismantling by the Supreme Court.

And now that things are looking up for VHC, must be time for Republicans to change the subject.

Oh, here we go.

A video from Vermont shows Obamacare architect Jonathan Gruber mocking a Vermonter who expressed concern about single-payer health care.

That’s better. It’s getting harder to challenge Obamacare and Shummycare on policy grounds, so let’s demonize somebody!

And filling the role, in the fine tradition of Hillary Clinton and Valerie Plame and Lois Lerner and Eric Holder and Hillary Clinton again and the hordes of illegal gangbanging youth swarming our borders (remember them?), not to mention Demon Number One, President Obama himself, is Jonathan Gruber, “architect” of Obamacare.

Let’s posit first of all that Gruber seems to be an arrogant ivory-tower type with no conception of how his ill-considered words sound in the wider world. To judge by the carefully-selected words spoken on a handful of videos trumpeted by the right, Jonathan Gruber is a proper asshole.

However…

To call Gruber the “architect” of health care reform is quite a stretch. His primary contribution was the development of an economic model that allowed the testing and comparison of possible reform measures. And from what I’ve read, the Gruber model is uniquely accurate. It’s a valuable tool, and Gruber’s been well compensated for its development and use. He’s been employed by the federal government and the Shumlin Administration (and by a whole bunch of other states) to use his model and consult on details of reform programs.

But he is not the architect of anything. Not in Washington, and not in Montpelier. He did not create the system; he was one among many. And he had nothing to do with the political strategy that led to its enactment, which makes his views on political strategy irrelevant.

You could call him the Ted Williams of health care reform. He’s a terrific power hitter. But he is not the manager or general manager, much less the owner. His thoughtless and arrogant remarks are no more relevant to health care reform than Ted Williams’ famous battles with the press were to his performance at the plate.

Convenient, isn’t it? Just when VHC is getting off the ground and Obamacare is starting its second round of successful enrollments, opponents of health care reform have “discovered” comments made by Gruber two and three years ago.

The video cited above was recorded in 2011 by the conservative website True North Reports.

And now — more than three years later — it’s the outrage du jour? How convenient.

The video’s existence was reported by Vermont’s own version of James O’Keefe, the Koch-funded Bruce Parker at Vermont Watchdog. His story was reposted by True North Reports — without comment on why a three-year-old video that True North Reports itself produced should be considered hot news today. What has TNR been doing with this video for the past three years?

By the way, the Vermonter who was mocked by Gruber in 2011?

El Jefe General John McClaughry.

As Gruber sits listening, the committee chair reads a comment from a Vermonter who expresses concern that the economist’s plan might lead to “ballooning costs, increased taxes and bureaucratic outrages,” among other things.

After hearing the Vermonter’s worries, Gruber responds, “Was this written by my adolescent children by any chance?”

El Jefe is shocked, shocked that Gruber would say such a thing. Although he’s certainly been called worse. And I myself have occasionally wondered if El Jefe’s opinion pieces might have been written in crayon.

In this particular case, McClaughry’s thunderings were so exaggerated, so over the top, that they invited mockery. And Gruber, unwisely, took the bait.

So now the Shumlin Administration is under pressure to take their irritable, impolitic slugger out of the lineup because he acted like a jerk.

Three years ago.

If you ask me, the Republicans are desperately changing the subject. They’re running out of time to undercut health care reform on its merits, so they’re demonizing one of its leading academics.

And, if you ask me, Jonathan Gruber’s remarks have no relevance to the merits of health care reform. None at all.

 

Is this the time for business as usual?

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It’s an annual rite at this time of year: a changeover in the upper levels of the administration. It usually involves some key departures, a shuffling of the deck, and the elevation of those who have served in a lesser capacity.

The latter began on Wednesday for the Shumlin Administration, with promotions for press liaison Sue Allen, campaign manager Scott Coriell, and education adviser Aly Richards. Loyal servants, rewarded for their work.

But should they be?

I have nothing against these folks. As far as I know, they deserve their promotions. But a broader question is on my mind:

Praise and promotions were freely distributed when Shumlin was riding high. Should the same be true after a poor administrative year and a disastrous campaign?

Further: Are these promotions a sign that Shumlin, at some fundamental level, doesn’t get it? That it’s business as usual on the fifth floor?

The Governor has made the right noises. But the current situation calls for a lot more than that. You can say “The buck stops here” all you want, but if the buck stops and gets tossed in a drawer, it’s a meaningless statement.

After the election, I saw a gleam of hope: Shumlin does his best work in crisis, as we saw after Tropical Storm Irene. This election was the closest thing to a personal Irene for Shumlin. My hope was that he would seize the opportunity, thoroughly evaluate everything he and his people do, and boldly set a new course.

So far, given his frequent deferrals to legislative leadership and his dispensation of Jobs For The Boys (And Girls), I’m having my doubts.

In addition to a personal reckoning by Shumiln, there ought to be a personnel reckoning. During the campaign, I wrote that the continued problems of Vermont Health Connect called for some clear direction and, probably, the rolling of some heads.

In addition to Doug Racine’s, that is. Racine may have had his failings at Human Services, but it wasn’t like he got a lot of help from Shumlin. Plus, he had little to do with Vermont Health Connect. He was expendable, not because he was the biggest problem, but because he wasn’t really part of the team. Mark Larson, who was far more responsible for VHC but was clearly one of the boys, was shunted to the side but kept his title and is still drawing a salary for duties and responsibilities unknown.

Is Governor Shumlin capable of evaluating his staffers and functionaries with the cold eye of reason, and demoting or defenestrating those who’ve contributed to his administration’s malaise?

We’ll see. He promises more personnel changes to come. But I have to say I’m not optimistic. If the changes have more to do with the desires and ambitions of his staff than with a sorely-needed overhaul of the Shumlin Machine, then his third term is off to an inauspicious start.

 

Shumlin: “We have a structural deficit” and other happy tidings

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The Governor addresses the multitudes. (The bearded man begging for change is Dave Gram of the Associated Press.)

The Governor addresses the multitudes. (The bearded man begging for change is Dave Gram of the Associated Press.)

An uncharacteristically subdued Governor Shumlin held an agenda-free news conference this morning. I emphasize “agenda-free” because his past practice has been to piggy-back news conferences onto photo opportunities or policy announcements, leaving much less time for general questions.

Today there were a lot of questions and a lot of substance. In no particular order…

— The Vermont Health Connect website will go back online this Saturday, which happens to be the first day of open enrollment. So the relaunch will come on the last possible day. Gee, hope things go right; there’s no margin for error.

Shumlin pronounced himself “optimistic,” saying “I’m encouraged by what I’m hearing.” But given how often he, and we, have been burned in the past, he was reluctant to make any predictions. “I’m always hoping it will work.”

— He dismissed Republican calls to shut down VHC and go with the federal exchange, and he had several good arguments. First of all, it’s far too late to make the change this year, so we’d be limping along with VHC for another year in any case. And there are signs it’s finally getting on track. “We’re turning a corner,” he said. “Why not give it a chance?”

There’s also the fact that the federal exchange’s premium subsidies aren’t as generous as Vermont’s. Switching to the federal system would mean higher premiums for thousands of Vermonters who earn between 100-300% of the poverty line.

And, as he pointed out, the US Supreme Court may well strike down federal subsidies, in which case only states with their own exchanges will be able to offer subsidies.

— Get ready for a slam-bang legislative session. Shumlin is still talking about the next step in health care reform (see below), the legislature is hell-bent on property tax and/or school funding reform, Shumlin is talking about significant changes to energy policy, and perhaps worst of all, the quote atop this post: “We have a structural deficit at this point.” Meaning huge challenges in fashioning a budget. That’s a hell of a lot of big, contentious issues to tackle.

Temba, his arms wide.

Temba, his arms wide.

— Speaking of the budget, Shumlin acknowledged that Vermont and many other states “thought the recovery would be more robust,” and its weakness has caused revenue shortfalls. He’s talking about a second round of rescissions in this year’s budget, although he said nothing is final just yet. And he’s talking about major changes in next year’s budget in order to put an end to annual budget crises.

He wants to put the state on a more sustainable path. Which must be making a few Republicans chuckle, since they’ve been preaching this for years. On the other hand, Shumlin has a valid point: the recovery has been weak. If we’d had a normal recovery with decent wage gains, our tax revenue would be stronger and we wouldn’t be facing this dilemma. The big news on this front is that the Governor now believes we’re facing years of sluggishness, and we need to ratchet down the budget to make it sustainable.

When asked whether this might mean tax increases, he didn’t rule them out, but he made it clear that his first choice is to rein in spending.

— On the push for single-payer health care, he repeated his longstanding support for the idea, but acknowledged that in the wake of the election, everything is on the table. He is aiming for a system that combines affordability with universal access to health care. His preference remains single-payer, but it’s looking like we might settle for less than that.

— He made it clear that yes, he won the election, and he has no doubt that he will serve a third term. He pointed to Vermont’s long tradition of electing the top vote-getter when no one wins a majority: ‘The person who gets the most votes, wins.” He cited the 2002 election for Lieutenant Governor, in which he and Progressive Anthony Pollina combined for a liberal majority but Republican Brian Dubie won the most votes; he and Pollina urged lawmakers to elect Dubie, which they did.

— On school funding and organization, he declared “We have a spending problem,” with high per-pupil costs and administrative structures. In some cases, he said, small class sizes can be harmful to achievement rather than helpful. He’s not in favor of mandatory school consolidation, but it’s clear he will push for consolidation by trying to convince local districts that it’s in their best interest.

He did mention the idea of “prioritizing funding to schools that voluntarily consolidate.” That kind of legislative payola may be effective, but it kinda stretches the definition of “voluntary.”

— In a less wide-ranging news conference, his comments on energy policy might have made headlines. They’re likely to get lost in today’s news. He noted the pending sunset of the SPEED program, which has helped spur the renewables industry in Vermont but has also created controversy because it allows the sale of “green” energy credits in other markets. He and the legislature are working on “ideas to replace SPEED.”

He was asked about the prospects for a carbon tax with offsetting cuts in other taxes — a plan likely to be announced tomorrow by a coalition of environmental groups. He was cool to the idea, saying “It’s tough for a small rural state to do it alone,” and pointing particularly to its impact on gas stations near our state borders. He prefers a regional carbon tax instead; but he said he’s had no conversations with other northeastern governors about the idea. Methinks the enviros will have a hard time gaining traction, when you combine Shumlin’s reluctance with an extremely busy legislative session.

— Finally, he was asked about marijuana legalization. He said he wants to wait until the release of a report on the idea in January before proceeding, but noted that “I support legalization. The question is “when.”

Signs of hubris in the VTGOP

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Vermont Republicans gained significant ground in last week’s election. But when you get right down to it, they’ve still got a long, long way to go. They didn’t field serious candidates for most of the statewide offices; they made nice gains in the legislature, but remain on the short end of big Dem/Prog majorities. They made progress on the back-office stuff, but they remain heavily out-organized and out-fundraised by the Dems.

And whatever made Scott Milne a serious contender in spite of a deeply flawed campaign with virtually no resources, well, can you bottle it and spray it on the next guy? Nope. I don’t think anyone really knows why Milne made such a strong showing, and I doubt it’s replicable.

My point is, the Republicans still have serious work to do. The VTGOP is not yet a serious contender — not statewide, not in the legislature. And already, there are signs that this whiff of success is going to their heads.

The most obvious sign is their eager acceptance of Milne’s reasoning for continuing the campaign into the legislature. Or should I say “Milne’s reasonings,” since he has a number of them on offer.

There’s the “ideological majority” notion, that lumps all of Dan Feliciano’s votes in with Milne’s, plus (I guess) most of Emily Peyton’s and Cris Ericson’s and Peter Diamondstone’s to, somehow, get Milne to 50% plus 1.

There’s the “incumbent rejection” idea: since most voters rejected the incumbent, that means the second-place finisher really won. In spite of the fact that more voters rejected Milne than rejected Governor Shumlin.

Then there’s the “legislative district” argument, which says that Milne won more districts than Shumlin and therefore demonstrated broader support. Which is obvious nonsense because many of Milne’s wins came in districts heavy on real estate and light on population.

And finally, we have the “there really isn’t a precedent” argument, in which Milne cites the handful of counter-precedents he can find — all of them emitting a fishy odor. The problem is, there really is a precedent, a very solid one; and when it hasn’t been honored, things have gone haywire.

In football, they say if you have two quarterbacks, you really have none. Well, Scott Milne has four arguments, but really has none. He’s throwing a whole bunch of stuff against the wall and hoping something sticks.

Among the people seeing through this are the two most popular Republicans in Vermont: Lt. Gov. Phil Scott and former Gov. Jim Douglas. Both have said that if it comes to the legislature, the top vote-getter should be elected. Here’s Douglas on VPR:

“It would seem to me unlikely that that would be a useful strategy and perhaps he should consider what Doug Racine and others have done historically which is to acknowledge the result and come back and fight another day,” said Douglas.

In 2002, Racine lost to Douglas by about 5,800 votes but since neither candidate won a majority, the vote went to the Legislature. Racine told lawmakers to vote for Douglas because he was the top vote getter.

… “It would seem to me that the good will that he’s accrued during the last several days ought to be preserved,” said Douglas.

I can kinda understand why Milne is sowing seeds of doubt; he came incredibly close to winning, which, in a way, must be harder to accept than losing decisively. (Gollum!) What’s harder to accept is that top Republicans like Don Turner and Joe Benning are grabbing at this logical apparition. Do they not, in Jim Douglas’ words, risk losing “the good will that [has been] accrued”? I think they do.

As they also do with their immediate call for repeal of Vermont Health Connect in favor of the federal exchange. They offer this as a serious proposal, but as VTDigger’s Morgan True reports, they haven’t worked out any of the details. Like how we’d make good all the premium assistance the working poor and middle class receive thanks to Vermont having its own exchange. Turner’s got a kinda-sorta plan for that, but he clearly hasn’t thought it through.

So why pull a half-baked cake out of the oven? The obvious answer is, to try to capitalize on the election results. And because the hubris is strong in the VTGOP right now.

Turner goes so far as to insist that VHC might need repeal even if it’s up and running when the legislature reconvenes.

Hmm, yeah, kill something that’s finally working after all the investment of money, time, and toil? Don’t think so.

The Republicans would do well to consider the letter and the spirit of Jim Douglas’ advice. Don’t get over your skis. Don’t, in the words of Gov. Shumlin, get too far out in front of the troops.

In renewing the war against health care reform, and in promoting the idea that the legislature should elect the second-place candidate, the Republicans show early signs of turning into the balls-to-the-wall ideologues we all love to hate in the national GOP. By now they should know that’s a recipe for disaster in Vermont. And it’s the opposite of Phil Scott’s alleged vision for a broader, more inclusive party.

A little diplomacy, a little statesmanship, might seem like a step backward right now. But it’s the best thing for the longer-term prosperity of the Vermont Republican Party.

Shumlin may have lost the center, but the worst damage was on his left

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Much of the post-election analysis has concluded that Governor Shumlin’s extremely narrow apparent victory is a repudiation of his more progressive policies (esp. health care) and that, in response, he’ll have to move toward the center.

There’s some truth in that. On health care, for instance, I really believe he’s got to get Vermont Health Connect up and running before he can expect anybody to support any kind of single-payer plan.

It'll take more than free food to win back the base.

It’ll take more than free food to win back the base.

However, there’s ample evidence in the unofficial election returns for a very different analysis: the Governor would have sailed to an easy re-election if he hadn’t lost the left wing. There were sizable numbers of liberal voters who (1) stayed home or (2) cast protest votes for Scott Milne, Dan Feliciano, or a write-in. (They felt safe doing so because Milne was such a weak candidate, ha ha, that nobody felt the need to cast a defensive vote for Shumlin.)

As for #1, turnout hit an all-time record low. ‘Nuff said. Conservative voters were motivated, liberal voters were uninspired. The rest of this post will explore #2.

Previously, I cited the vast difference between Shumlin’s vote total and Congressman Peter Welch’s. In the final unofficial results (posted Saturday on the Secretary of State’s website), Welch received a total of 123,349 votes.

Shumlin got 89,509.

That’s a difference of nearly 34,000 votes. To put it another way, more than one-quarter of all Welch voters did not vote for Peter Shumlin.

That’s a stunning figure. But wait, there’s more.

I checked Shumlin’s totals in four Democrat-friendly state Senate districts: Bennington, Windham, Orange, and Washington.

In the Bennington district, Gov. Shumlin got 6,522 votes. He badly trailed Dem incumbent Dick Sears, who got 7,965 votes. That’s over 1400 Sears supporters who did not vote for the Governor.

In the solid blue Windham Senate district, the Governor’s home turf, he was outpolled by Sen. Jeanette White, the top vote-getter for two Senate seats, by a margin of 7777 to 6758.

More than a thousand votes lost, in the county he’s lived almost his entire life.

In Orange County’s Senate district, Shumlin trailed incumbent Democrat Mark MacDonald by 561 votes — MacDonald’s 3797 to Shumlin’s 3236. Which was virtually identical to MacDonald’s margin of victory over his Republican opponent, Bob Frenier.

In fact, if Frenier had equalled Scott Milne’s total and MacDonald had equalled Shumlin’s, the Senate seat would have flipped to the Republicans. So a sizeable number of Orange County voters split their tickets, opting for the Milne/MacDonald combo platter.

In the three-seat Washington County district, Shumlin drew 9,173 votes. That’s almost 2,000 behind top Democrat Ann Cummings (11,167) and 1300 behind Prog/Dem Anthony Pollina (10,474).

Reminder: The Prog/Dem Pollina was, by far, the most liberal of the Senatorial candidates in Washington County. He was believed to be vulnerable to a strong challenge from Republican Pat McDonald. In the end, Pollina was re-elected by a substantial margin.

Governor Shumlin trailed Anthony Pollina, ardent supporter of single-payer health care and higher taxes on the wealthy, by 1300 votes. Those numbers undercut the dominant narrative, that this election’s message was to go slow and move to the center. Pollina ain’t moving to nobody’s center.

Add those four districts, and Governor Shumlin lost more than 5,000 votes compared to the top Democratic Senate candidates.

In short, if the Governor had simply held onto his base, nobody would be talking about a Scott Milne squeaker.

In addition to all these numbers, I can tell you that every liberal I’ve heard from since Tuesday has told me stories about diehard Democratic voters who simply could not bring themselves to vote for Shumlin. That’s anecdotal evidence, but there’s a lot of it around.

I’m sure the Governor lost plenty of votes in the center. But he shouldn’t take this election as a mandate to shy away from progressive policies, and Republicans should be cautious about claiming 2014 as a mandate for them. This election was less about ideology than it was about disappointment in and distrust of Governor Shumlin.

The left wing of the Democratic Party has had its doubts about Shumlin from day one. He was seen as more of an opportunist, a triangulator, than other Democratic contenders in 2010. He placated the left by touting his opposition to Vermont Yankee and promising an all-out push for single-payer health care. During his two terms in office, he has done little to earn the respect of the left, and done much to forfeit their trust. His 2013 push to cut the Earned Income Tax Credit was seen as a betrayal on the left, as was his continual opposition to any sort of tax hikes on top earners. The awful performance of Vermont Health Connect is a mortal threat to single-payer.

If he wants to make a comeback, establish a legacy for his governorship, and perhaps try to run for a Congressional seat one day, he would be well advised to make peace with Vermont liberals instead of turning himself into Phil Scott Lite.

p.s. Yeah, I know, there are lots of liberals who already see him as Phil Scott Lite. Particularly “lite” on the perceived honesty and integrity of our Lieutenant Governor. 

$20,000,000 is the least of our problems

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Big scoop came out Friday. As first reported by VPR’s Peter Hirschfeld, the still-troubled Vermont Health Connect could cost the state as much as $20 million extra this fiscal year — for expenses that the federal government might decide not to cover.

The story got some legs, although it came out in the journalistic dead zone of Friday afternoon. It was picked up by other outlets and became kind of a big deal.

And it was the best possible thing that could have happened to the Shumlin Administration. 

Why do I say that? Because it sucked the oxygen out of that particular room, leaving a much bigger VHC story flailing in its wake. (Mixed metaphor? Sorry.)

The story, by VTDigger’s Morgan True, included the $20 million bit, but also revealed a host of other problems with VHC. The story paints a bleak picture of a system still in disarray, and facing big new challenges in less than two weeks.

The problems, in rough order of appearance in True’s narrative:

— The VHC website will be up and running in time for the new open enrollment period, which starts on Nov. 15. But previously insured customers seeking to renew will be asked to stay away from the website and instead fill out a paper form and submit it by mail. The reason: More of this year’s “customer service frustration” is expected by health care reform chief Lawrence Miller. Great.

— As open enrollment looms, there’s still “a mountain of old problems” that will be impossible to resolve by the 15th. So the masters of health care have come up with a kludge: they’ll keep the old cases active with tricks like fake zip codes, even as they’re working on new cases.

Gee, that sounds like a sure-fire plan. Nothing can go wrong with loading fake zip codes into an already wonky system, can it?

— The state’s contract with its new contractor, Optum, hasn’t been renewed yet. If it’s not by the end of business Monday, the company won’t continue to work and “‘Vermonters will not be renewed and will lose coverage,’ according to a document obtained by VTDigger.”

— The state has failed to keep up with required income verifications for “thousands of Medicaid beneficiaries,” which is “a growing concern of the feds.” If some recipients turn out to be ineligible, the state could be on the hook for their medical bills.

— This is more of a problem than you might think because “during the past year, people were hastily added to the state’s Medicaid rolls in order to close out their cases and get them off the hands of overworked employees,” according to the anonymous VHC worker.

— One anonymous VHC worker reported internal problems with Optum employees making mistakes, being poorly trained, being shuttled in and out of state frequently, and “a lack of ownership on the part of mid- to lower-level state employees,” who believe that if the system fails, Optum will take the heat.

— The motives of Optum and other contractors are being questioned by a top VHC official, who pointed out in an Oct. 15 memo that the contractors “have financial motivation to protract their term of employment… to generate profit.” He says the state needs to find a path forward that gives contractors a reasonable profit but ensures that Vermont doesn’t pay too much.

— “Many of the state employees… are temporary workers.” Some have been working on VHC for over a year, which is far longer than is allowed for temp staff. Unlike regular, unionized state employees, the temps don’t get any benefits, just a straight hourly rate.

— Because some coverage has tax implications and VHC staff are not trained in that area, there’s a fear that thousands of VHC customers could find themselves with an unexpected tax bill come April.

This is all on top of the potential $20,000,000 shortfall. Which is bad enough, but now you know why I say the Shumlin Administration should thank its lucky stars that it was Hirschfeld’s story that got spread around and not Morgan True’s far more detailed, far more damaging one.

Oh boy, oh boy, it’s last-minute dirty tricks time

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The Republicans are targeting potentially vulnerable Democratic lawmakers with a mailer repeating the conservative lie that the Shumlin Administration wants to “take over” Medicare.

I’ve seen two mailers, identical except for the specific candidates involved. One is for Addison County Republican hopeful Valerie Mullin, and it targets incumbent Dems Mike Fisher and David Sharpe. The other is on behalf of Republican John Mattison, who’s challenging incumbent Herb Russell of Rutland City.

The Mullin flyer bears the return address of “Friends of Valerie Mullin,” her campaign committee, but it clearly was not produced by her campaign because, as I said, it’s identical to the Mattison flyer.

I’ve only seen these two, but it wouldn’t surprise me if identical mailers hadn’t been sent in all districts where a Republican has a chance to knock off a Democratic lawmaker.

So let’s review. In Act 48, the 2011 health care reform bill, there was a provision calling for the state to pursue administration of Medicare as part of single-payer health care. This provision is what’s called “session law,” and was intended as a guideline rather than a mandate.

“In 2011, we asked the administration to entertain lots of things, but it was in the context of ‘tell us whether you can do this,’” said Rep. Mike Fisher (D-Lincoln), who was on the House Health Care Committee when it drafted Act 48.

Administration officials subsequently discovered that the feds wouldn’t allow Vermont to manage Medicare. It was impossible in any case, because Medicare for the entire Northeast is in a single administrative district. Vermont would have had to take over the entire region, which was clearly out of the question. This year, Act 48 was amended and the provision was dropped.

Which hasn’t stopped the desperate Republicans from repeating the lie. And now they’ve produced mailers trumpeting the lie.

Bottom of the barrel, guys. Bottom of the barrel.

Here’s a picture of one flyer, for your edification:

MattisonMedicare

 

The Mullin flyer is identical except for the names of the candidates.

Hack’s retreat

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The conservatives really thought they’d gotten hold of a hot one.

They’d suddenly “discovered” a Shumlin Administration plan to “take over” Medicare, and began furiously stoking fear among Vermont seniors. Or at least trying their best to do so. As if they really gave a damn about Medicare, considering that their party is actively trying to kill it for future enrollees. And that their favored candidate, Dan Feliciano, is a Libertarian and presumably doesn’t believe in relying on the gubmint for anything.

It took a few days for the Administration to put together a coherent response, perhaps because they were incredulous that anyone would take this seriously. But their response did come, and it was simple and categorical: There is no such thing.

First word actually came from VTDigger’s Anne Galloway, who reported that the pertinent clause in Vermont’s health care reform law had been amended last spring, and that the law no longer mentioned anything like a takeover.

Which, as I predicted, didn’t stop the anti-reform crowd from pushing the idea. Here’s a Twitter exchange between Agitator-in-Chief Darcie “Hack” Johnston and Yours Truly, beginning with a Johnston link to a fear-stoking radio ad produced by the Ethan Allen Institute:

Funny, I didn’t get a response to that last one.

Meanwhile, El Jefe General John McClaughry leaped into the fray with a partial retreat, posted as a Comment under Galloway’s story. In it, he tried to muddy the legal waters before concluding that apparently there would be no Medicare takeover — but instead of admitting the whole hoopla had been pointless, he posited that the Administration was “trying to squirm out” of their alleged intent to take over Medicare. He further congratulated Dan Feliciano, the one who first tried to peddle this bill of goods, for supposedly uncovering the Shumlin plot and forcing the Governor to abandon it.

Like I’ve said before, sometimes I think ol’ Jefe doesn’t really mean the stuff he writes; he’s just trollin’ us.

Later in the day came another VTDigger story, amplifying Galloway’s initial post. This time, Administration officials had joined the chorus.

Robin Lunge, director of Health Care Reform, said unequivocally Monday that it won’t happen.

“Federal law does not permit us to get the cash,” she said.

Reporter Morgan True then explained that the troublesome portion of Act 48, the 2011 health care reform bill, called for the state to pay for all health services “to the extent possible under federal law.” And as Lunge stated, federal law doesn’t permit such a move.

Further, True reported:

That portion of Act 48 is what’s known as session law, or the legislation as passed before it is written into statute.

It provides guidance for writing the statutes, and while it is still law, the portions that don’t make it into statute are often temporary and meant to provide guidance.

“In 2011, we asked the administration to entertain lots of things, but it was in the context of ‘tell us whether you can do this,’” said Rep. Mike Fisher (D-Lincoln), who was on the House Health Care Committee when it drafted Act 48.

And after all that, remember that this year’s Legislature repealed that section of Act 48.

Johnston, of course, was prepared with a fallback position: “if the state is allowed” to set payment rates for medical services “and determine the type of payments, it will be bad for seniors on Medicare.”

Please note the first word: “if”. The whole argument is based on her own assumption.

From there, it’s just a quick hop and a step to the conservatives’ favorite bugaboo: rationing!!!

Scary

It’s a quick, and nearly complete, comedown for Johnston and her ilk. From frightening stories of a Shumlin plot to take control of Medicare and screw around with seniors’ benefits, to a maybe-possibly-perhaps shift in reimbursements. So sad when a good conspiracy theory gets thoroughly blown up by the facts.

The ironic thing about all of this is the notion that hardcore conservatives are suddenly the Protectors of Medicare. Don’t I recall Mr. McClaughry, just a few weeks ago, pining for the good old days before we had all this Social Security and Medicare and Medicaid crap that was draining our independence and sucking the lifeblood out of the private-sector social safety net that somehow, magically, took care of everyone’s needs?

If you’re interested in protecting federal health insurance, I’d advise you that Governor Shumlin is a much better ally than the likes of Darcie Johnston.