Vermont Single-Payer Financing Plan Released

By Andrew Stein for

The Shumlin administration released two financing plans Thursday evening: one for funding a publicly financed health care system and another to pay for portions of the state’s new health benefit exchange.

The much-anticipated single-payer financing plan provides more of a map of the state’s health care finance landscape than it does a course of action through it. The document itself alludes to the need for a plan with substantive revenue-generating measures.

“A future financing plan will likely feature a substantial and regular individual and employer contribution, similar to current law, albeit one paid through a public system,” the plan says.

The plan — which was drawn up by the University of Massachusetts for a price tag of $300,000 — estimates that the total savings of reforming the system would be about $35 million in 2017. The total $5.91 billion cost of the system would place a burden of $1.61 billion on taxpayers, after federal funding, and a $332 million chunk would be placed on employers who continued to enroll their employees on their insurance plans after the system takes effect.

While the plan points to a slate of tax bases for raising such revenues, the architects of the plan acknowledge the lack of information they had to work with — and, therefore, the potential inadequacy of their findings.

“Many details regarding the structure of a single payer system in Vermont have not been determined,” they write. “These details may significantly affect the assumptions underlying our models and therefore the results of our models.”

When Gov. Peter Shumlin and the Legislature approved Act 48 in 2011, they set the state on a track towards a publicly financed health care system. Part of that legislation called for a financing plan to be submitted to the Legislature by Jan. 15, 2013, that “shall recommend the amounts and necessary mechanisms to finance Green Mountain Care and any systems improvements needed to achieve a public-private universal health care system.”

On Thursday, Director of Health Care Reform Robin Lunge said the plan met the statutory goal.

“It has amounts, and it has necessary mechanisms included; it just doesn’t have one,” she said. Furthermore, she added, the plan seeds the Statehouse for constructive debate over how to pursue and implement such a health care system.

Jeffrey Wennberg, who runs the anti-single payer group Vermonters for Health Care Freedom, panned the report for its lack of substance.

“The report … contains surprisingly little information within its 91 pages,” he said in a public statement. “There is no multi-year budget or projection, and the Act 48-required recommendation for a funding source is completely absent.”