Jeremy Parke: This commentary is written by Ethan Parke of Montpelier, a former member of the Vermont Health Policy Council, a co-founder of the Vermont Consumers’ Campaign for Health, and a current board member of Vermont Health Care for All. The bill in the Senate provides health insurance to legislators but not to other residents of Vermont.
This comes at a time when numerous citizen advocates have been pleading with legislators to seriously consider providing all Vermont residents with publicly funded primary care. Just that is what a bill in the House, H.156, and a bill in the Senate, S.74, would do. However, neither of these bills has the support of committee chairs or legislative leadership, so it is unlikely that they will be discussed.
Legislators may not be aware of this situation’s irony. An alarming number of Vermonters are now considered to be underinsured, which means that they would be forced into personal bankruptcy in the event of a serious illness or injury. This spring, eligibility for Medicaid is expected to be tightened; Consequently, the number of uninsured Vermonters will undoubtedly rise in the near future.
Disappointed to treat patients who delay or self-ration their care, as well as the ever-increasing administrative complexity and inadequate reimbursement, primary care clinicians are leaving the field.
Many people, including possibly some legislators, are unable to afford to purchase subsidized insurance through Vermont Health Connect. S.39 would not have been introduced otherwise. The high deductibles mean that the Health Connect plans do not cover basic care or even things like a broken arm, an asthma attack, or a work-up for chest pain for working Vermonters who do not qualify for Medicaid.
Starting in January of next year, the sponsors of S.39 are eager to solve this issue for themselves. Sadly, the remaining members of our group will continue to wait.
Legislators shouldn’t be denied affordable health care, of course. Naturally, they should, but everyone in Vermont is just as deserving. In point of fact, the principle that public funding for health care should be universal was enacted into law by the Legislature in 2011. Isn’t it selfish of legislators to prioritize their own health care needs over those of their constituents now?
The Joint Fiscal Office was asked to estimate how much it would cost taxpayers to provide legislators with health insurance from state employees. For a single person, these plans cost $12,500 per year, for a couple, $25,000 per year, and for a family, $34,000 per year. The Joint Fiscal Office based its estimate on an 80/20 cost split between the state and the legislator, as is typical for state employees, despite the fact that S.39 states that the insurance would be provided to legislators “at no cost.”
The JFO analyst estimated that the annual tax revenue required for the state share would range from $900,000 to $2.5 million, depending on the mix of individual and family plans, if fifty percent of legislators signed up and paid twenty percent of the premiums.
What other uses might such funds have? Dental care is frequently cited as the most pressing need among both insured and uninsured Vermonters, and $2 million could pay for 10,000 dental cleanings and routine oral exams for those who do not have access to it. Alternately, ten thousand primary care visits to monitor and treat diabetes, high blood pressure, and other common conditions could be paid for with $2 million.
“Government is, or ought to be instituted for the common benefit, protection, and security of the people, nation, or community, and not for the particular emolument or advantage of any single person, family, or set of persons who are a part only of that community,” states Article 7 of the Vermont Constitution.
S. 39 goes against the spirit of Article 7 by providing benefits and protection to a select group while disregarding the similar requirements of the general public.
The solution is to publicly fund health care for all 645,000 Vermonters, not to deny legislators the benefits, security, and protection of state law. We could get there with the help of H.156 and S.74, but only 180 people who live in the Statehouse for four and a half months a year would be covered by S.39, which is in the Senate Government Operations Committee.
