MONTPELIER — The state Senate on Tuesday passed a health care benefits exchange bill that will allow Vermont to fulfill the requirements of the federal Affordable Care Act, while setting stage for more substantial reforms in the future to help those who are uninsured or underinsured.
Two Addison County lawmakers played significant roles in advancing the bill, H.559, through both legislative chambers. Rep. Michael Fisher, D-Lincoln, is chairman of the House Health Care Committee, while Sen. Claire Ayer, D-Addison, is chairwoman of the Senate health and Welfare Committee.
The House passed the health care benefits exchange bill in February by an 88-38 tally. On Tuesday, the Senate followed suit, endorsing it by a 20-7 margin.
H.559 sets up a benefits exchange that would, among other things:
• Allow customers to enroll in “qualified health plans” on-line, by phone, or by mail. Qualified health plans would provide the essential health benefit package set forth in the Affordable Care Act. Those essential benefits must include emergency care, maternity and newborn care, laboratory services, prescription drugs, mental health and hospitalization.
• Provide service (by 2014) to citizens who do not have employee-sponsored insurance, and to small employers (50 workers or less) that offer coverage to all full-time employees.
The exchange would involve four private insurance companies, with the state assessing eligibility of applicants, according to Ayer.
“The bill was basically a housekeeping bill — moving personnel and budgets back and forth between the banking, insurance and health care office and the Green Mountain Care Board so they can do the jobs that we have asked them to do,” Ayer said.
Still, the Senate did add a few provisions, Ayer said, including one aimed at containing the co-pay costs for expensive prescription drugs for uninsured or under-insured people suffering from grave illnesses.
Other than that, Ayer said the bill puts Vermont on a path to conformance with federal law and, potentially, a single-payer, universal access health care system. But officials are aware the U.S. Supreme Court is currently hearing a case on the Affordable Care Act and could strike down some, or all, of its provisions.
H.559 is now headed for a conference committee to reconcile any differences between the House and Senate versions. Ayer does not anticipate any problems in that arena, as the Senate bill closely mirrors the House version.
Once it clears conference committee, the bill will head to Gov. Peter Shumlin for his signature to make H.559 law. Shumlin has been a strong advocate of health care reforms.
“I’m very hopeful we have finished this year’s piece and can move forward,” Ayer said, noting more work lays ahead.
Reporter John Flowers is at [email protected].