Health care reform effort stalls in Statehouse

BRISTOL — Local lawmakers on Monday served notice that legislation aimed at creating publicly financed primary health care in Vermont will not advance until next year, at the earliest.
Sen. Claire Ayer, D-Addison, explained there has not been the needed support from the administration of Gov. Phil Scott, now in his first term of office.
She told participants at Monday’s legislative breakfast at the Bristol American Legion Hall that the lack of Scott’s support has meant few resources from the administration to hire experts to help design and “operationalize” a universal primary care system. Such a system would cover Vermonters for trips to a physician, who can diagnose illnesses earlier and prescribe treatment before the patient requires more serious and expensive services.
“It’s hard to get the administration to talk about this, because they are not in favor of it,” Ayer said of universal primary care.
“We have limited resources.”
The Legislature in 2011 passed Act 48, a single-payer health care law that then- Gov. Peter Shumlin ultimately determined was too costly for the state to pursue. Advocates have now been rallying around bills that would give Vermonters greater access to health care providers.
Ayer hopes a primary care bill will gain traction during the 2018 session.
Other discussion at Monday’s breakfast focused on:
•  Act 250. Act 250 is Vermont’s 47-year-old land use law through which a development plan’s potential impact on the environmental and the community are weighed against 10 criteria. Developments must secure an Act 250 permit if they are to proceed. The law has drawn its share of praise, but also criticism from those who believe its standards are too stringent and at times unevenly applied.
Lawmakers this session are considering a bill, H.424, calling for Act 250 to be re-examined and potentially updated to work more efficiently for Vermonters.
“We are looking for a more simple and direct process without compromising the quality of the (permit) outcomes,” said Sen. Chris Bray, D-New Haven.
The review seemed particularly timely since Act 250 is approaching its 50th birthday, Bray noted. The late Sen. Art Gibb of Weybridge is credited with being the architect of Act 250.
The bill would, among other things, create a commission to review Act 250 and recommend ways of improving it. The commission would solicit public feedback to shape its recommendations to the Legislature.
There are eleven Act 250-related bills in the legislative hopper this session. One of them is H.194, sponsored by Rep. Fred Baser, R-Bristol, which proposes to waive Act 250 review for major affordable housing developments in towns with at least 10,000 residents. The initiative, Baser explained, is designed to encourage developers to fill a substantial affordable housing void in the state’s housing stock.
“It’s not happening organically,” Baser said, citing permitting costs as an impediment.
“Housing sometimes gets lost in the (legislative) rush, and it shouldn’t.”
Bray cited S.100 as another affordable housing bill being considered by lawmakers. The bill calls for, among other things, more bonding for affordable housing projects and adjustments to permitting rules to pave the way for more low-cost, energy efficient homes.
•  S.51, a bill calling for the state to make measurable progress in its goal of deriving 90 percent of its energy from renewables by the year 2050. Bray said the bill is currently languishing in the House Natural Resources & Energy Committee, where it has not garnered enough support to be voted out. Bray said some of those committee members don’t feel S.51 is aggressive enough. Bray, chairman of the Senate Natural Resources & Energy Committee, said he hopes the bill will come up for a House vote before the end of the session — either on its own, or as an add-on to another bill.
•  An unsuccessful attempt this session to legalize possession of small amounts of recreational marijuana in Vermont. Middlebury attorney Dave Silberman, a longtime advocate for legalization, voiced his frustration that the latest effort has stalled.
“What’s the alternative (to legalization)?” Silberman asked lawmakers. “There are 108,000 Vermonters who use marijuana annually, they spend about $200 million a year in the black market with criminal drug dealers. If we are not going to legalize, what are we going to do?”
Lawmakers at Monday’s breakfast said they did not see a rush to tackle the issue in 2017.
“We’ll have to live with the situation we have now until next year,” Baser said. “There’s no alternative.”
Bray agreed that passing a pot bill is not in the cards until 2018, at the soonest.
“When a controversial bill like this is pulled off the floor, that is probably it for this session because there is not the will in the building to take it up and pass it out of the House,” Bray said. “There’s nothing coming to the Senate, and the Senate won’t, in the closing three weeks, take up a bill of that scale and send something over to the House.”
•  Legislative gridlock. Some participants at Monday’s breakfast seized upon a comment recently made by Rep. Dave Sharpe, D-Bristol, who said that this has been one of the most frustrating sessions  in his 15 years in the House.
Baser took a stab at interpreting his colleague’s comment, in his absence. He theorized that an almost complete turnover in key leadership posts in Montpelier — including House speaker, Senate president pro tem and governor — has temporarily slowed communication and therefore productivity.
“Even with the brightest people in those scenarios, it takes time to get the engine warmed up,” Baser said. “A lot of bills haven’t moved off the wall. I think that will get better.”
Ayer agreed.
“There are a lot of new people and names,” Ayer said. “We haven’t developed those relationships yet.”
•  Mandatory vaccinations against measles, chicken pox and other illnesses. The Legislature a few years ago passed a law removing the exemption that allowed parents to decline vaccinations for their children based on philosophical reasons. Parents can still refuse shots for their children based on religious and medical reasons. Addison resident John Ball urged lawmakers to reverse their decision on the philosophical exemption, pointing to research he said links some vaccinations to serious medical conditions, including autism.
Ball added there appear to be more sick children in the United States since the late 1980s, when Congress passed legislation exempting vaccine manufacturers from liability.
“There’s a huge fire with a lot of smoke that needs to be looked at again,” Ball said of the issue.
Ayer has become very familiar with the issue as a chair of the Senate Health & Welfare. She questioned the credibility of studies asserting health risks from vaccinations.
“The issue is about ‘herd immunity,’” Ayer said of the importance of immunizations. In essence, a disease can more easily take root in a population with a large group of children who have not been vaccinated, Ayer said.
•  H.3, the so-called “green burial bill,” that would reduce the minimum burial depth for a body from the current 5 feet to 3.5 feet. Advocates believe the lower burial threshold will better facilitate decomposition. The measure passed the House and was expected to get a green light from the senate this week.
Gov. Phil Scott will be the featured speaker at the next legislative breakfast on Monday, April 24, at St. Peter’s Parish Hall in Vergennes. Like all of the breakfasts it start at 7 a.m., with the program beginning at 7:30 a.m. and ending at 8:45 a.m.
Reporter John Flowers is at [email protected].

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