Gov. Scott urges restraint on health care reform: Seeking more clarity on Obamacare

VERGENNES — Gov. Phil Scott used Monday’s legislative breakfast in Vergennes to lobby for state lawmakers’ support for some of his budget priorities, and to note differences between him and fellow Republican President Donald Trump on such issues as immigration and health care reform.
Scott was making his first-ever appearance at an Addison County legislative breakfast as governor. For roughly an hour, he discussed his first 100 days in office and fielded questions on a variety of topics, ranging from climate change to the state’s policy on annual vehicle inspections.
He devoted a chunk of his limited time to health care, and specifically the concept of universal primary care. Lawmakers have been studying the feasibility of a publicly financed system to pay for Vermonters’ visits to physicians and health specialists. Such a system, supporters argue, would encourage citizens to visit their family doctor sooner and more regularly, thereby reducing the need for more invasive and expensive procedures in the future.
Sen. Claire Ayer, D-Addison, and chairwoman of the Senate Health & Welfare Committee, has voiced concern about a lack of resources this year to properly research a universal primary care law. Lawmakers have filed two bills — H.248 and S.53 — that propose to establish universal primary care in Vermont by 2019.
Scott on Monday said he is inclined to wait and see what the Trump administration will do to the federal Affordable Care Act (ACA) and Medicaid program subsidies before endorsing any major changes to the state’s health care system.
Scott said the initial health care reform plan pitched by Trump and GOP leadership in the U.S. House “wasn’t going to work, I believe, for Vermont. We are very reliant on federal funds here; about half our budget is based on federal funding. That (Republican) initiative would’ve put thousands of people off health care and also provided hundreds of millions less in funding.”
Federal officials are back at the drawing board drafting new health care funding changes that could result in a repeal of the ACA and/or a reduction in Medicaid reimbursement to the states.
“We’re trying to anticipate what’s going to happen, but that’s difficult,” Scott said. “We’re hoping cooler heads will prevail.”
Scott was asked on Monday if he would support spending state resources to study the feasibility of universal primary care. He reiterated his call for a wait-and-see approach.
“Currently, about one-third of our population is somehow connected with Medicaid,” he said. “So regardless of how we feel, we’re so reliant on federal funding that we have to take that into account. We don’t have the capacity to make that difference up. It really is dependent on what they do, then we can move forward from there. (A study) isn’t going to reduce the hundreds of million of dollars we could potentially lose if they repeal the Affordable Care Act.”
Vermont, he said, will be keeping close tabs on what happens in the nation’s capital.
“We want to make sure Vermonters are protected,” Scott said. “I think we have put a pretty good team together … We are working our way through, trying to work with the administration in D.C. and our Congressional delegation and other governors throughout the country to make sure that whatever (the feds) put in place doesn’t have detrimental effects on Vermont.”
Scott discussed a variety of other topics at Monday’s breakfast, including:
•  His transition from candidate to governor.
Scott spoke of the post-election challenges of hiring a team, drafting budget priorities and setting his sights on fulfilling campaign pledges. Drawing from his experience as a builder, politician and race car driver, Scott said he measured his key administration hires against what he called “the four C’s”: that they be competent, committed to the job ahead, possess character and integrity, and that they have chemistry with their colleagues.
Scott believes his team members possess all those traits, with “chemistry” being the most desirable and often elusive quality.
“You can have all the most qualified and talented people together in one room and never, ever achieve success because you don’t have that chemistry,” Scott said.
He also promised to seek regular feedback from state workers at all levels, and not just from managers.
“During my inauguration, I talked a lot about my vision for Vermont,” Scott said, adding that vision must also be shaped by the perspective of “people in the trenches and on the front lines.”
•  His pledge to not raise fees or taxes for the fiscal year 2018 state budget. Scott praised the House for passing a budget that he said allows him to keep his pledge. He said he hopes the Senate will also endorse a spending plan that keeps taxes and fees level.
•  Opioid addiction. Scott gave kudos to his predecessor, Gov. Peter Shumlin, for highlighting the addiction problem a few years ago. Scott promised to support prevention and treatment programs for people suffering from addiction and those at risk. With that in mind, Scott recently signed an executive order establishing a Vermont Opiate Coordination Council, led by a “director of drug policy.” The council, according to the executive order, will “lead and strengthen Vermont’s response to the opiate crisis by ensuring full interagency and intra-agency coordination between state and local governments in the areas of prevention, treatment, and law enforcement activities.”
Drug addiction, Scott said, “affects every single one of us … We’re taking this very seriously.”
•  Vermont’s mandatory vaccination policy. Scott was asked if he would support restoring the philosophical exemption that allowed parents to exclude their children from mandatory vaccinations. Some Vermonters said there is research alleging a link between some vaccinations and autism. Residents can still exempt their children from vaccinations for medical or religious reasons.
Scott said he supports the notion of mandatory vaccinations, adding “we’ll continue to monitor the situation.”
•  Auto inspections. Bristol resident Peter Grant voiced concern about how illumination of a “check engine” light on a dash can prevent the vehicle from passing inspection — even if a mechanic determines no significant problem with that vehicle.
Scott noted a current bill, H.232 that would allow a vehicle to pass inspection with a “check engine” light on, so long as the signal is not denoting a safety problem. Scott said he supports such a bill and favors efforts to keep vehicles on the road so that people can get to their jobs in rural Vermont.
“I think we should be looking at our entire inspection process … and see if there are any other (rules) that don’t make sense,” Scott said.
Rep. Dave Sharpe, D-Bristol, spent more than two decades teaching automotive programs at career centers in Middlebury and Essex. He agreed the state should review its auto inspection system, but cautioned that while a “check engine” light activation could be the result of a faulty sensor, it often signals emissions problems.
“If the light is on, (the vehicle) is polluting,” Sharpe said.
•  Migrant workers. Scott acknowledged the importance of migrants — many of them undocumented, from Mexico — to the state’s agricultural industry. And he said it is in the state’s best interest to have a more ethnically and racially diverse population, in part to reverse the graying of Vermont’s population. Vermont is educating 20,000 fewer children that is was two decades ago, according to Scott.
“We need more immigrants coming into Vermont if we are going to right-size our workforce,” Scott said.
He acknowledged the Trump administration’s proposed crackdown on immigration and the impact that could have on the state’s farm workers. Scott has come out in favor of bill S.79, which “proposes to promote public safety by protecting Vermont residents from compulsory collection of personally identifying information, or dissemination of that information for purposes of establishing a mandatory federal registry or database.”
“With the new administration, obviously our views on immigration are different,” Scott said. “I believe our state and local law enforcement are … looking at those breaking the law and not looking to round people up.”
•  Affordable housing. Scott has asked the Legislature to support his call for a $35 million bond to create more affordable housing in the state. He said the current lack of affordable homes is one of the state’s chief impediments to attracting more young families.
“Anything we could do to attract more housing for them would be beneficial,” said Scott, who also wants Vermont to invest more in early childhood and higher education initiatives.
Reporter John Flowers is at [email protected].

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