Vermont Approves Single-Payer Health Care: ‘Everybody in, nobody out’

[Scuba]

http://www.occupydemocrats.com/vermont-makes-promise-people-video/

The ACA provided states with federal funds to institute a Medicaid expansion. The states chose to expand the program also were able to set up their own state exchanges, which were relatively free from the problems the federal site had. Vermont decided to take it a step further by setting up their very own single payer system.

The slogan of the program: Everybody in, nobody out.

The program will be fully operational by 2017, and will be funded through Medicare, Medicaid, federal money for the ACA given to Vermont, and a slight increase in taxes. In exchange, there will be no more premiums, deductibles, copay’s, hospital bills or anything else aimed at making insurance companies a profit. Further, all hospitals and healthcare providers will now be nonprofit.

This system will provide an instant boost the state economy. On the one side, you have workers that no longer have to worry about paying medical costs or a monthly premium and are able to use that money for other things. On the other side, you have the burden of paying insurance taken off of the employers side, who will be able to use the saved money to provide a better wage and/or reinvest in their company through updated infrastructure and added jobs. It is a win-win solution.

...

45,000 Americans die every single year because they cannot afford treatment, are you ready for that? That is 15 times the amount of people that died during the September 11, 2001, attacks, or perhaps for you Righty’s out there you would rather see it put this way, 11,250 times the amount of people that died in the Benghazi attack. That equals 5 Americans that die every hour, of every day, of every year because of a preventable illness that was not taken care of due to lack of access and means.

[xchrom]

1. du rec.

[malaise]

2. This should have been the ACA

and will eventually cover everyone

[IronLionZion]

9. It has to start somewhere.

One state at a time like in Canada.

[passiveporcupine]

93. Yep!

Where is that dancing banana...I am so excited, and I don't even live in Vermont.

[IronLionZion]

99. woot

[mattclearing]

84. This is what the ACA makes possible. n/t

[MannyGoldstein]

89. Why wasn't it possible before? nt

[stillcool]

90. I know the answer to that..

Nobody wanted it..the way some states still don't want anything to do with Obamacare, or civil rights, or voting rights.

[mattclearing]

94. It was possible before, but my point is that the ACA was an achievable stepping stone.

If the filibuster had fallen sooner, who knows how far it could've gone.

I do think we should be happy that states have been given a large building block towards a humane system.

Not satisfied, but it's a big step.

[Doctor_J]

95. It was.

the fan club is putting some mustard on the turd sandwich that is the ACA.

[JimboBillyBubbaBob]

91. Yeah,

I'm with you.

[cali]

3. As a Vermonter, I appreciate the nod. As the nitpicker I am,

I can't help but note the factual errors in this piece.

Vermont was not the first state to pass Marriage Equality.

We don't yet know how single payer in Vermont will be funded. Payroll tax is the most likely, but how it will be funded is still up in the air.

the hospitals in VT won't become non-profits because all of them- all 18 of them- already are non-profit.

I do think that the legislature (super majorities in both House and Senate) and the governor are committed to making it work. And Vermonters support single payer.

[Scuba]

4. Thanks, cali, for the corrections!!!

[morningfog]

13. To nitpick, Vermont was the first state to PASS marriage equality.

It was the first state to pass marriage equality through the legislative process. Prior to that highest courts of MA, CT and CA had ruled same-sex marriage a constitutional right.

CA, through Prop 8, also had repealed that right by the time VT passed marriage equality.

[moxybug]

24. Payroll taxes make the most sense

Increase taxes by the average amount that people already pay for medical insurance either through their employers or on their own.

The single biggest peeve I have when I see/read discussions of single payer, is the hand wringing from the centrist crew about ALL the evil NEW TAXES that will be raised to pay for it.

Almost never do I hear the argument made that employees ALREADY pay taxes to the Insurance companies each month. It can be at worse a wash. With the for profit angle removed and common sense legislation to curb customer gouging it can actually save people in the long run in real dollars.

As an unabashed liberal I applaud the Sate of Vermont for doing the right thing.

[Scuba]

32. No reason capital gains should be exempt from the tax, as stockholders will be covered too.

Why give those who earn all their income from owning, rather than working, a free ride?

[antigop]

35. because they're the "job creators"! (sarcasm) nt

[loudsue]

42. Good thinking, Scuba! I totally agree.

It's time the ownership class started making a few strides toward civility for their country at large.

[Enthusiast]

46. +1 a whole bunch.......nt

[moxybug]

49. I wholeheartedly agree

It was not my intention to exclude other forms of revenue that might be tapped in addition to payroll taxes to pay for single payer health care. I would love it if the bottom feeders on wall street gave back for the common good.

I was merely stating my distaste of the meme that says single payer will cost everyone more because taxes will go up. This meme leaves out that your payroll deductions for for profit insurance premiums and copays will go to ZERO.

Sorry if you got the impression that I have anything but utter distain for wall street.

[Scuba]

50. Not at all. I just wanted to make sure capital gains got mentioned.

[grantcart]

77. The problem with taxing capital gains in a state is that

the people with big capital gains will "move" to a state that doesn't tax and have a "second home" in Vermont.

In the end you will only collect capital gains from middle class folks.

Same is true with inheritance tax. Both are too fungible to be effectively taxed (more than a nominal amount) statewide.

You could have a surplus tax on property but you would have to have an exemption for middle and low income by exempting the first $ 200,000 of a home, for example.

Probably the best way is to spread it around with small increases in various taxes so no one part of the economy bears to great a burden.

[Scuba]

78. The aim is to get the wealthy to pay their fair share. You're correct that the very wealthy ...

... can play one state off another with capital gains and luxury taxes, among other forms of taxation.

But I can't see letting the Koch brothers move to Vermont and get healthcare while paying little or no taxes to the State (theoretically possible since they have no payroll income and could purchase all their goods out-of-state).

Bottom line, wealthy people shouldn't become even more of a burden on hard-working, middle-class and poor families.

[SheilaT]

71. Another aspect of this paying for healthcare thing I often get into arguments over,

is the fact that we collectively are already paying huge amounts into the current system one way or another. Either through the cost of an employer-based system, or an individual plan, or paying for the healthcare of those who do not have any insurance. We currently are doing it in the most expensive way possible, and a lot of people act as if somehow the current system is free.

[sabrina 1]

115. Excellent point. The hugely expensive Insurance Premiums are never mentioned. Nor the fact that

they don't even cover medical expenses when people actually need them.

Eliminating these huge extortions to the Ins Business and replacing them with a much lower tax which would cover everything, no copays etc, always made sense, but our Health Care is is controlled by Corporations and their interest in not in Health CARE, it is in Health Insurance.

The fact that so many people die in this country from something that could be so easily fixed, is a national disgrace.

[Enthusiast]

45. We have to consider how much Vermonters are currently spending for health care.

That money will be directed away from for-profit insurance companies toward care. Even if it involves a payroll tax it will still ultimately be cheaper, much cheaper and more fair, way more fair.

[hfojvt]

65. payroll tax though?

yuck.

Less progressive than an income tax.

Vermont's taxes are actually not bad now. They tilt slightly in favor of the top 20% over the bottom 20%, but most of that tilt is because of deductions to federal taxes that the top 20% benefit from.

http://www.itep.org/pdf/vt.pdf

[tsuki]

83. I am wondering what will happen to Workers' Comp. As an employer,

I insured my employees during work hours with Workers' Comp (15% of payroll), $50 a truck per month, at home time, and future medical care (1.45%).

Everyplace I lived with single payer, Workers' Comp was salary or wage replacement only and dirt cheap.

Will Workers' Comp medical to insurance companies be replace with to single payer?

[hughee99]

85. Just curious, as you seem to be well informed on this, will those for-profit organizations become

"non-profit" or "not-for-profit"?

[cali]

108. what for-profit organizations are you specifically referring to?

[hughee99]

113. The article said all hospitals and health care providers will now be non-profit.

I assume those that were already would be unaffected, but I was asking about those that aren't already.

[cali]

119. ah, all hospitals are already non-profit in VT

I don't know about health care providers or what falls into that category under the law- but the majority already are non-profit.

[davidpdx]

117. Correct

We have universal healthcare here in Korea and it is funded by payroll tax and partially by government. The tax I believe is 5.8% (I would expect it to go up to 6% next year). We also have a flat VAT tax as well of 10% (while I don't agree with it, I can't do much to change it. The tax is already integrated into the price of things so you only see the amount of the tax on the receipt, it is not figured in addition to the price of the goods like the sales tax in California or other places).

Here is a link to the rates:

http://www.nhis.or.kr/static/html/wbd/g/a/wbdga0404.html

[Demeter]

5. Hail Vermont, Cradle of Independence and Sanity!

Let's take this idea and run with it!

[Laelth]

6. Congratulations, Vermont! k&r n/t

-Laelth

[Fumesucker]

7. Moscow girls make me sing and shout

Sorry, just anticipating the reaction from the Baggerati.

Everything reminds me of a song these days.

[cali]

8. Moscow, Vermont, of course.

http://en.wikipedia.org/wiki/Moscow,_Vermont

[Fumesucker]

11. Poifect!

[flamingdem]

56. Ha ha ha! And Berlin not far away

I thought of that as well

[davidpdx]

116. Cool

I grew up listening to them and Bread.

[cali]

10. Oh, one more thing about the VT experiment:

Controlling costs is a big piece of it and the legislature has passed laws doing just that- regulating hospital price increases, etc.

[pangaia]

26. " the legislature has passed laws ........ regulating hospital price increases, etc."

EEEEIIIIIII !! SOCIALISM !!!! COMMUNISTS are running VT.
It must be because it is so close to Canada.. yet another Commie infested country.

[grahamhgreen]

59. It's the domino theory coming down from Qubec, eh?

LOL

[Enthusiast]

47. That is encouraging......nt

[Ian_rd]

12. Wow! First step toward national single-payer?

If this system is a perceived success, then it could serve as an example to the rest of the country.

[Swede Atlanta]

20. I wouldn't hold my breath........

Despite the fact that Romneycare is generally recognized as having been highly successful in reigning in rising medical costs and insuring nearly all Massachusetts residents, the GOP won't give it credit.

Those that admit it has been fairly successful qualify by stating that that is only in one state and not a blueprint for the nation.

Then there are those that claim it has been a huge failure.

So even if single payer is hugely successful in Vermont I do not expect the right wing to acknowledge its success or even for those that do, they will claim that it works in that relatively sparsely populated state full of tree huggers and would never work in a "real" state like Texas.

These people don't accept facts for facts. They make up their own facts to support their ideology.

I cheer for the people of Vermont in this development. Good luck!!!

[jeff47]

54. Yep. The ACA moves the single-payer fight to the states.

And it will be an easier fight for us in the blue states. The successes in the blue states will let us take on the purple states, and successes there will let us either return to the national battle or take on the red states.

Ironically, the states that refused to set up their own exchanges will probably go 'de-facto single-payer' faster. A public option on the federal exchange would suddenly make those states de-facto single-payer states.

[Half-Century Man]

14. Our second step

On the way to recognizing the right to be healthy
The first was the ACA
The third will be national acceptance of single payer
the fourth will be national medical marijuana
the fifth will be food labeling
the sixth will be cleaning up of the horrible mess unregulated industry has left us with.

[Mopar151]

15. This will be a major economic boost for Vermont

If for nothing more than what it will do for small employers, multi-employer workers and the self-employed. And, IMHO it just made VT THE place in the eastern US for tech and manufacturing startups.

[Scuba]

16. +1

[cali]

18. Actually, Vt has a very healthy tech startup scene

Dealer.com, MyWebgrocer, etc.

Manufacturing? Not so much. That would be great.

[Mopar151]

19. Hey, I'm a little "old school"

I shoulda said "Technology" or sumthin', maybe? I tend to think "tech" encompasses more than IT - but I'm not saying any of it is bad!

[DirkGently]

17. And so it begins ... ?

Let us hope.

[cantbeserious]

21. Kick And Recommend

eom

[polichick]

22. Let's hope this is the first of fifty! (Although it might take some states fifty more years.)

[SidDithers]

23. This is how national single payer starts...

And maybe Peter Shumlin will one day be recognized and revered as Tommy Douglas is in Canada.

Well done Vermont.

Sid

[Victor_c3]

25. I can't wait to see how this works out for them

An important first step in gathering data that will (hopefully) show how much more efficient, cost effective, and better overall single payer is for the population.

With solid supporting data and facts comes an easy way to win arguments.

[mountain grammy]

27. K&R for Vermont leading the way!

How come people in Vermont are so smart, Mommie?
Well, dear, it's that "Freedom and Unity" thing doncha know!

[mmonk]

28. When do the snows begin to melt in Vermont? May make a visit next year.

[Scuba]

29. Beats me. But here in Wisconsin most of the snow is usually melted by the 4th of July.

[mmonk]

33. I can use that as a barometer I suppose.

Looking to start a new business in 2014.

[Scuba]

37. Oh. Well in that case, it's actually very nice here, a good refuge from global warming.

Educated workforce, terrific parks and a place to go to college that's top 5 in the WORLD!

BBC names Madison one of the top 5 university towns in the WORLD

http://www.bbc.com/travel/feature/20131119-living-in-great-university-towns/1

Our governer (sic) sucks Koch dick, but otherwise we're a nice State on a Great Lake!

[flamingdem]

57. Yes but I was there during horrible flooding in 2012

The state is still digging out.

So while some climate change is not hurting VT, other kinds are and there has been damage done to the ecosystem of course.

[City Lights]

30. Woo-hoo, Vermont!

This is excellent news!

[Moostache]

31. I am running out of reasons for not living in Vermont already!

If this is how we have to get to national single payer, then so be it...but big cheers to the people of Vermont!

[liberal N proud]

34. Fantastic -maybe it can be the model for the country in the NEAR future

[oberliner]

109. Yes cause the rest of the country is so similar to Vermont

Sarcasm icon.

[on point]

36. Finally some sanity and an example for others

[oberliner]

110. Vermont is not an example for others

There is no other state with its demographics in the US.

[cali]

111. there are other states with similar demographics

and demographics are not the only driver.

[FourScore]

38. (And sadly, those deaths mentioned in the commentary include children.) GO VERMONT!!!!

Watch America as this state has an economic boom!

[yesphan]

39. Excellent !

It will be interesting to see how they handle the influx of people moving to Vermont.
How long does one have to live there to be eligible ?

[lonestarnot]

40. Yeah Vermont!

[Enthusiast]

41. Yay, Vermont! Kicked and recommended plus one!

Get rid of Republican governors and Republican legislatures and single payer can spread across the nation!

[mucifer]

43. Now if we could just have President Bernie all will be right in the world!

Or our little corner of it.

[Alkene]

44. Thank you, Vermont. Could you please send a letter of recommendation to Wa. St.? n/t

[adieu]

48. It's not quite win-win...

The insurance companies lose big time. Aww...

[yurbud]

51. I hope it spreads

[CrispyQ]

52. In a civilized society, some things are just not done for profit.

Good for Vermont. I wonder if you will hear about this on the 'news?'

[Lex]

55. Exactly so.

[lovuian]

53. I love this state

they are progressive!

[Spitfire of ATJ]

58. Now all they need to do is void all prior medical bills....

There are STILL going to be people who could lose their homes.

[Scuba]

62. Great idea! Hope someone is working on it.

[MadrasT]

60. K&R - GO VERMONT!!!

[grahamhgreen]

61. May I suggest Dems use thes words, " If the R's don't like the federal website, they can simply move

to single-payer, like Vermont has."

[Scuba]

63. + a boatload of recs

[LittleBlue]

64. Vermont is so awesome

Makes me envious. I hope Washington does this soon.

[littlewolf]

66. really stupid question. Does the state control how much

medical professionals make? is that part of the cost control?
the hospitals being non profit I understand, and since they already
are non profit will have zero impact. but usually the hospital contracts
nurses, Dr.'s, and others (sometimes EMT's work for hospitals because
of shortages.)

[Scuba]

68. Vermont hospitals will have to offer competitive salaries to their clinicians and other workers ....

... or risk losing their workforce to other states.

I'm not an expert on Vermont's healthcare law, but to the best of my knowledge it does not have salary controls but it does have cost controls.

[IrishAyes]

67. Hooray for Vermont! One down, forty-nine to go!

[raging moderate]

69. The Green Mountain Boys ride again!

Good for you, Vermont!

[ErikJ]

70. I heard 1500 doctors have promised to relocate to VT if they did this

win-win-win

[Auntie Bush]

81. I hope that's true. We sure need them...hard to find Drs. to move here due to the snow and cold.

Not too many move away due to the weather. Once they get here...they quickly acclimate and LOVE it here. We can have 60 miles between street lights and drive for 50 miles with no traffic.

[EC]

72. Good for them.

You know what really pisses me off? This could have been WI. Doyle was working on single payer and I'm sure Barrett would have done it even before the ACA was signed. But with Walker nothing good will ever happen in WI.

[Scuba]

73. Yep. Teabaggers. I'll never forgive them.

[EC]

74. yep.. n/t

[Wounded Bear]

75. Re: WI election....

Probbably why the Coke Bros (did I misspell that? put such an effort into getting their shitbird governor elected.

[EC]

76. That

plus they needed a place to put their coal dregs from Michigan. There is a coal refinery being planned in Kenosha now and all those piles of filth that they moved from Michigan to Chicago is going to be brought here next I'll bet (since Chicago is telling them to leave with their dirt, poison and grime).

[R. P. McMurphy]

79. VERMONT ROCKS!!! n/t

[ut oh]

80. Very awesome .... e.o.m.

[blkmusclmachine]

82. ,

,

[HockeyMom]

86. Vermont is light years ahead

of the rest fo the country, on so many issues. Kuddos to those in that beautiful state!

[Live and Learn]

87. So cool. Excellent news. WTG Vermont! nt

[Comrade Grumpy]

88. We need this nationwide. Fuck those parasite insurance companies.

[mother earth]

92. Bravo VT!!! nt

[ProSense]

96. As state legislatures permit,

more states could soon take the VT route. Fortunately, VT was ahead of the game.

Study: States Can Learn From Vermont’s Health Care Reform

Kirk Carapezza

<...>

A study published this week in the New England Journal of Medicine says other states can learn some lessons from Vermont in rolling out health exchanges that are essential to the federal Affordable Care Act.

Doctor Laura Grubb at the University of Texas wrote the report. In a phone interview Wednesday, she said other states should follow Vermont administrators' lead and take matters into their own hands.

"As opposed to having a mandate from above pushing it at you, instead, they decided to take their own initiative and go with what was best for the people of Vermont," Grubb said

In her study, Grubb points out that Vermont created the Green Mountain Care Board to slow the rising cost of health care. She says administrators have worked to reduce redundancy and improve transparency, while developing a state-exchange that will be 100 percent federally funded...The state has been awarded more than $250 million in federal funding for its state health exchange...

- more -

http://www.vpr.net/news_detail/98021/study-states-learn-from-vermonts-health-care-refor/

Single Payer movement in the era of Obamacare

by Shockwave

If you believe that healthcare is a basic human right and understand why Single Payer IS the final destination of healthcare reform and you want to get it done as soon as possible, read on.

<...>

If you are involved in the Single Payer movement in California this diary may help you understand what we face and whet we can do to get things done.

I am one of those Single Payer activists who understands that Obamacare will benefit many and it is truly amazing that this effort, that President Obama should get full credit for, is the best that could come from a dysfunctional and extremely polarized DC.

And I support those who keep up the fight to prevent its sabotage by all the Republicans in red states and in DC.

I consider the ACA a giant first step towards an America where healthcare is recognized as a basic human right and there is a system that allows ALL who live here to have access to affordable medical attention without the fear of going bankrupt.

And I understand that California is leading the country in the implementation of Obamacare. But it's not about being better than other states like Texas and Georgia where Obamacare is being sabotaged or ignored. It's about joining Vermont to help lead the country to a place where ALL are covered, where the private insurance blood suckers are gone, where medical results and costs are in line with other developed nations, where if you need to see a doctor (or a dentist) you make an appointment and you don't worry whether you will be able to pay the rent (given that 76% of all Americans live paycheck to paycheck).

So how do we get it done? <...>

Bill Zimmerman has just published an article that sets the tone;

Why California can lead the way to Single Payer in the U.S.

Recently Public Citizen, a member of California’s AllCare Alliance, released a report entitled, “A Roadmap to Single-Payer: How States Can Escape the Clutches of the Private Health Insurance Industry.” “We’re looking for a few pioneering states with the courage and fortitude to let common sense prevail over the insanity of our current patchwork system, “said Lisa Gilbert, director of Public Citizen’s Congress Watch division. “Once they succeed, we expect most opposition to single-payer and our reliance on privately insured health care to become historical relics.”

By the time California votes to move to a single payer system – the earliest date possible is 2017 when the Affordable Care Act allows states to set up their own systems – Congress will have gone through two more election cycles. Voters will be less white, and probably less conservative, and the changing composition of the House of Representatives may allow for passage of single-payer waiver legislation for states, perhaps even with “state’s rights” support from a few Republicans.

California, Vermont and possibly other states moving to single-payer will put increasing pressure on Congress to grant other state waivers. Once subject to such pressure, Congress could theoretically pass a federal bill to give (improved) Medicare to all, but it is politically far more likely that they will simply let the states set up their own systems, which can then become models for a larger federal program. California, once again, could be the engine driving national change.

One of the features of Obamacare is the "waiver". The idea is that states can apply for this "waiver" and implement their own plan starting 2017 if this new plan covers more people and is affordable.

So lets take a look at what the ACA says about the "innovation waiver";

SEC. 1332 ø42 U.S.C. 18052¿. WAIVER FOR STATE INNOVATION.
(a) APPLICATION.—
(1) IN GENERAL.—A State may apply to the Secretary for the waiver of all or any requirements described in paragraph
(2) with respect to health insurance coverage within that State for plan years beginning on or after January 1, 2017. Such application shall—
(A) be filed at such time and in such manner as the Secretary may require;
(B) contain such information as the Secretary may require, including—
(i) a comprehensive description of the State legislation and program to implement a plan meeting the requirements for a waiver under this section; and
(ii) a 10-year budget plan for such plan that is budget neutral for the Federal Government; and
(C) provide an assurance that the State has enacted the law described in
subsection (b)(2).

So this is the milestone that any state has to go through. The Vermont single payer activists lead the way. Even Vermont will apply for the "innivation waiver" to get federal funds starting in 2017 to help pay for their Single Payer system.

Here in California the Single Payer organizations (linked logos below) will announce soon the plan to achieve the "waiver" milestone by January 1st 2017. The Single Payer plan that will be proposed will be based mostly on SB 810, which was approved by SEnate and Assembly twice and vetoed twice by Arnold Schwarzenegger and in 2012 it was stopped by 6 blue dogs in the Senate before it could get to Jerry Brown's desk.

In California, one of the key issues is that Obamacare will leave out over 3,000,000 undocumented workers. These 3,000,000 are an integral part of our society and mostly but not all are Latinos. And as Joan McCarter pointed out, Latino organizations worry about funding for Obamacare outreach efforts;

Hispanic health centers and community organizations say they don’t have the funding or resources to carry out the complicated sign up process for the 10 million Latinos who will be eligible for new public and subsidized health coverage options.

Latino organization outreach is a key to success.

And we should coordinate the efforts around the country.

So here in California we need to work with Sacramento at all levels. It will be a lot of hard work but there are thousands of committed activists.

One way you can help is by joining one of the Single Payer organizations and help us organize and direct the grassroots movement that will be instrumental in convincing Sacramento to go along.

And this week on Thursday August 1st you can join other activists to watch The Healthcare Movie in Santa Monica at 7:30PM and celebrate the 48th anniversary of Medicare. You can buy tickets here.

- more -

http://www.dailykos.com/story/2013/07/30/1226609/-Single-Payer-movement-in-the-era-of-Obamacare

Note:

Kos Media, LLC Site content may be used for any purpose without explicit permission unless otherwise specified

Remember Section 1332 of the health care law?

State single payer waiver provisions in the Senate healthcare bill - legislative language and fact sheet from Vermont Sen. Bernie Sanders

Why the 1332 Waiver in the Senate Health Reform Bill is the Only Opportunity for State Single Payer Systems Under the Bill

The health care reform bill passed by the Senate requires that all states set up Exchanges through which private insurance companies could sell their plans. Because federal laws preempt state laws, the federal health care reform bill would supplant any state attempt to set up a single payer system in lieu of an Exchange, which by its nature calls for multiple payers to compete. If the Senate bill is enacted, the only opportunity for states to move toward a single payer system is found in Section 1332. This section would allow a state with a plan that meets certain coverage and affordability requirements to waive out of the requirement to set up an Exchange for private insurance companies. Only with such a waiver could a state move in the direction of a single payer system.

- more -

http://www.pnhp.org/news/2010/march/state-single-payer-waiver-provisions-in-the-senate-healthcare-bill-legislative-langu

Release: President Endorses State Waiver Proposal

Vermont Delegation and Gov. Shumlin Hail Obama Endorsement of State Health Reform Waiver Legislation

WASHINGTON, Feb. 28 - The Vermont congressional delegation and Gov. Peter Shumlin today hailed President Obama's endorsement of legislation allowing states to provide better health care at a lower cost starting in 2014.

At a meeting of the National Governors Association Monday morning, Obama announced his support for amending the Affordable Care Act to allow states like Vermont to seek a federal waiver to the new law three years earlier than currently allowed. States would be required to design plans that are at least as comprehensive and affordable as the federal model and cover at least as many people

Last month Sens. Bernie Sanders (I-Vt.) and Patrick Leahy (D-Vt.) introduced in the Senate and Rep. Peter Welch (D-Vt.) introduced in the House legislation that would advance the date waivers would be accepted from 2017 to 2014. The three joined Gov. Shumlin at a Montpelier press conference to announce the legislation, which would provide Vermont the flexibility it needs to adopt reforms Shumlin is pursuing.

Leahy said, "This is a wise decision that keeps in focus the goal of continually improving health care in America. I applaud President Obama and Secretary Sebelius for supporting efforts by Vermont and other states to go above and beyond what the Affordable Care Act requires. They know that the federal government does not have a monopoly on good ideas, and innovations by the states will prove - and improve --- the benefits of health insurance reform, on the ground, and in practice. While some in Washington want to turn the clock back and repeal the new health reform law, Vermont and other states want to move ahead. Vermont has already been working hard to improve the state's system of health care, and passage of the delegation's waiver bill will move our state one step closer to that goal."

Sanders said, "At a time when 50 million Americans lack health insurance and when the cost of health care continues to soar, it is my strong hope that Vermont will lead the nation in a new direction through a Medicare-for-all, single-payer approach. I am delighted that President Obama announced today that he will, in fact, support allowing states to innovate with health coverage models sooner rather than later. I worked hard to draft and secure the waiver provision in the health reform law and I am very pleased the president now agrees that we should make it available in 2014 as originally intended. While there is a lot of work to be done, I look forward to working with Sens. Leahy, Wyden, Inouye, Brown and others in the Senate and Rep. Welch and others in the House to get this done as soon as possible."

Welch said, "President Obama's support for allowing states to innovate sooner is a good news for Vermont and all states looking to tailor health care reform to individual states' circumstances. This legislation will give Vermont a green light to lead the nation in providing quality health care at a lower cost. I'm hopeful that Democrats and Republicans alike will support this practical step to give states flexibility to achieve progress their own way."

Shumlin said, "I was excited to learn about this today during a visit to the White House. All along officials from Health and Human Services have expressed a willingness to work with us, as long as we don't compromise standards under the law. I think this is an excellent example of how we can work together to control skyrocketing health care costs and implement meaningful health care reform as soon as possible."

A fact sheet on the delegation's "State Leadership in Healthcare Act" is available here.

http://www.sanders.senate.gov/newsroom/news/?id=44a664de-8e92-43f4-a871-d26e0b5a252d

FACT SHEET

"State Leadership in Healthcare Act‟

Section 1332 of the Patient Protection and Affordable Care Act – the “Waiver for State Innovation” – allows states to waiver out of some of the requirement of federal health reform if they meet certain standards. The provision in the new law was authored by Sens. Bernie Sanders (I-Vt.) and strongly supported by Sen. Patrick Leahy (D-Vt.) and Rep. Peter Welch (D-Vt.).

The Sanders-Leahy-Welch “State Leadership in Healthcare Act” moves the availability of state waivers from 2017 to 2014. This would allow a state to avoid the expense of setting up an exchange – which is otherwise required in every state in 2014 – only to dismantle it later.

The federal waiver would allow a state to:

a) Collect all the federal funding and use for financing coverage for individuals through a plan designed by and for that state.
b) Coordinates this waiver process with Medicare, Medicaid and CHIP waiver processes that may be required depending on the design of the system. The state

The federal waiver would not allow a state to:

a) Offer lower quality or less affordable care to their residents than would be available in the exchange.
b) Obtain waivers from the health insurance market reforms implemented under the law such as those benefiting ending the use of pre-existing conditions to exclude individuals from coverage or those allowing young adults to stay on their parents’ plans longer.

How does the waiver provision of the law work?
Step 1: The state passes a law to provide health insurance to its citizens.
Step 2: The Secretary of Health and Human Services and Secretary of the Treasury review the state law and determine that the plan is:

a) At least as comprehensive as its residents would receive in the exchange;
b) At least as affordable;
c) Deficit neutral to the federal government; and,
d) Covers at least as many people.

Step 3: If the federal government finds that the alternative state system meets these requirements without certain federal rules, states can get a waiver. The state plan could receive waivers from:

a) The section requiring establishment of the exchange
b) The designs for how federal subsidies would have to reduce premiums and co-pays.
c) The employer penalty for providing coverage
d) The individual mandate.

http://www.sanders.senate.gov/graphics/011411state_waiver_fact_sheet.pdf

The Affordable Care Act: Supporting State Innovation
http://www.healthcare.gov/news/factsheets/2012/02/state-innovation02222012a.html

[Scuba]

97. Wisconsin's poised to follow suit in just a few thousand years.

[SunSeeker]

98. I'd move there if it weren't so freakin' cold.

But if I didn't have insurance, I'd do it. I'm lucky; I have decent insurance, and live in CA which has the next best thing: a state program that embraces the ACA. Hopefully CA will follow Vermont's lead soon.

[1StrongBlackMan]

100. I’m loving this; but …

Must take issue with a single point in the article:

you have the burden of paying insurance taken off of the employers side, who will be able to use the saved money to provide a better wage and/or reinvest in their company through updated infrastructure and added jobs.

More likely, the savings will go into the business owner’s pocket … especially, in the publically held businesses.

[MindMover]

101. Hallelujah .... the sun is shining in Vermont ...

[Kennah]

102. The shit's gonna hit the fan when Limpballs hears about this

[RBInMaine]

103. GOOD!

[YOHABLO]

104. Let's hope there is a domino effect .. unfortunately the southern states won't go there.

[idwiyo]

105. k&r

[ismnotwasm]

106. This is what we need

Right on Vermont

[klook]

112. "Go back to sleep, Bob."

"Honey, wake up. You won't believe the dream I just had. Well, don't you want to hear about it?"

"All right, Bob. What is it?"

"I was in innkeeper in this crazy little town in Vermont."

"I'm happy for you. G'night."

"N-nothing made sense in this place. I mean, the maid was an heiress. Her husband talked in alliteration...the handyman kept missing the point of things. And then there were these three woodsmen. Only one of them talked. And everybody had single-payer health care!"

"That settles it. No more Japanese food before you go to bed."

"And I was married to this beautiful blonde."

"Go back to sleep, Bob.
...
What do you mean, a beautiful blonde?"

"Go to sleep, Emily.
...
You know, you, uh, you really should wear more sweaters."

[woo me with science]

114. K&R Love Vermont.

[Enthusiast]

118. Kicked

[RoccoR5955]

120. If memory serves me correctly,

This is how it was done in Canada. One province went for universal healthcare, then the rest followed.
True they have fewer provinces than we have states, but, as Bernie said, New York, or California could be next to go that way, when they see that it is working in Vermont.

Any way, those damn Green Mountainers. What kind of commies do they think that they are?
I may have to move there when I retire, so that I can join them! Just six short years until I can.
And what if someone from NY goes to VT, and gets hurt or something, and needs care? I wonder if it is also universal? Who knows, they might end up with a surplus of finances for healthcare, if they don't have to pay the insurance company executives their multi-million dollar salaries.