By Darcie Johnston
All-Payer Waiver: Remember the major brouhaha last year when word leaked that the Shumlin administration was trying to pull Vermonters’ Medicare into their single payer health care scheme? The administration roundly denied it over – and over – and over again. Robin Lunge, Shumlin’s Director of Health Care Reform must have denied it ten different ways; most notably, “We’re not going to change Vermonters’ Medicare benefits.” Well yes, you are. And here’s how.
The Shumlin administration has been pursuing an “All-Payer Waiver” from the Feds for at least the past year. The waiver would eliminate the current fee-for-service payment model used by physicians. All payment rates, including Medicare’s, would be rolled into a single payment system run by the Green Mountain Care Board. The GMCB would control Vermonters’ Medicare funds, and would set the rates that Medicare will reimburse docs and hospitals. This system would replace the current Federal Medicare payment system for Vermont’s seniors.
VHCF believes that an all-payer waiver is a slippery slope to a single payer health care system. Under single payer, the state would provide the only health care plan that residents could use. Under an all-payer waiver, private insurance plans would remain, but provider reimbursement rates would be set at the same level for all plans.
There is a very real concern that Vermont seniors will not be able to find the care they need here in Vermont, because the state’s all-payer waiver and tinkering with Medicare reimbursements will drive out physicians, who can practice in other states without the restraints.
Additionally, if the state controlled Medicare funds, what would happen to seniors who travel or seek health care out of state? Docs and hospitals across the country will take “regular” Federal Medicare, but would they accept “Vermont” Medicare, which is likely to pay less? Would they even know what “Vermont” Medicare is? Don’t forget – the whole idea is for Vermont to pay less than would otherwise be paid.
The Shumlin administration is well-known for dealing in half-truths. The half- truth here is that sure, we won‘t change your Medicare benefits, but good luck getting those benefits either in Vermont or elsewhere in the country. Vermont seniors deserve the assurance that no matter where they go, their Medicare benefits are safe and intact.
S.139 includes $862,767 in funds to pursue an all-payer waiver, of which $184,636 is General Fund money. The Green Mountain Care Board’s authority is increased and it gets another three positions.
On April 30th Reps.. Morrissey and Browning offered an amendment to S.139 to strip from Act 48 the requirement that “Green Mountain Care shall assume responsibility for the benefits and services previously paid for by the federal programs, including Medicare.” The Democrats and Progressives defeated it on almost a straight party line vote 54-85.
- This is a guest Commentary by Darcie Johnston, Executive Director of Vermonters for Healthcare Freedom.