Vermont Watchdog | January 19, 2017

Date: 
January 20, 2017

Outlook: Vermont on the brink of an Affordable Care Act repeal

With an Affordable Care Act repeal on the horizon, Vermont’s leaders are trying to predict the future amid changing messages coming from Washington.

“People want certainty, and there isn’t any,” state Sen. Jane Kitchel, D-Caledonia, chair of the Senate Committee on Appropriations, told Watchdog. “One day, [Trump] is talking about repealing the ACA, and then he says he wants to provide coverage for everyone. At this point, all we can do is track the situation closely.”

According to the George-Soros-funded Center on Budget and Policy Priorities, Vermont is poised to lose $3 billion in federal funding over the next 10 years if the law is repealed. Moreover, 35,000 Vermonters stand to lose insurance coverage....

While Vermont operates a state health care exchange, the state is intricately connected to the ACA through Medicaid.

Sarah Lueck, senior policy analyst at the Center on Budget and Policy Priorities, a progressive think-tank focused on policies that impact low-income Americans, told Watchdog that each state will have to evaluate the greatest areas of need based off of individual demographics. In Vermont, that demographic is likely to be low-middle-class Medicaid users.

Vermont has the most expansive Medicaid coverage of any state. The ACA expanded eligibility for low-income adults, but Vermont also negotiated a global commitment waiver with the federal Centers for Medicaid and Medicare Services. The waiver further expanded Medicaid coverage by allowing the state to determine wider eligibility and finance programs like the Blueprint for Health.

Because Medicaid is so expansive in Vermont, certain brackets of beneficiaries are likely to face cuts. ...

Republicans have proposed dramatic changes to Medicaid structure, such as giving states control through block grants. Past Republican budget proposals have also included a per-capita spending cap intended to reduce spending by $1 trillion over 10 years. Critics say the funding reductions will hurt states’ abilities to continue with innovative health programs, such as Vermont’s Medicaid waiver. [...]

Michael Fisher, chief health care advocate at Vermont Legal Aid, a nonprofit law firm created by the Legislature protect Vermont consumers, said his office is ready for whatever plan Republicans present. “We will work with every fiber of our beings to make sure we have improved access to care,” he told Watchdog. [...]

Fisher encourages Vermonters to contact state and federal representatives if they are concerned about their health care. Since no one knows the future, elected officials need to know “what does the average Vermonter feel.”