Mushrooming Medicaid Costs Create a State Budget Crisis
Medicaid, a 50-year-old government health insurance program for the poor and disabled, is in the crosshairs of some state policy makers because of its skyrocketing cost. In the past five years, total spending for all the services tucked under Vermont's Medicaid umbrella rose $366 million. The state and federal governments share the annual cost, which came to $1.7 billion last year. Of that, Vermont paid $738 million.

Consumer advocates get nervous when they hear talk of shrinking eligibility and benefits. "I'm pretty worried about any of the alternatives other than finding another revenue source," said Trinka Kerr, the state health advocate [and director of Vermont Legal Aid's Office of the Health Care Advocate]. "They would hurt people. If you reduce some benefit, that has a downstream impact on people's health."

Obama Admin To Update Rules for ACA Special Enrollment Periods

On Monday, the Obama administration announced it will tighten the requirements for special enrollment periods, which allow U.S. residents to enroll in health coverage through the federal exchange outside of the Affordable Care Act's regular open enrollment period, the Wall Street Journal reports (Armour/Radnofsky, Wall Street Journal, 1/12).

Meanwhile, consumer advocates said they have not seen any evidence suggesting individuals are misusing the special enrollment periods. Christine Speidel, a lawyer at Vermont Legal Aid, said, "Most consumers are confused by the rules on special enrollment periods and do not understand the system well enough to try to game it."

Shumlin looks to curb driver’s license suspensions

Gov. Peter Shumlin is calling on lawmakers to eliminate the more than 70 nondriving-related reasons for which a person can have his or her driver’s license suspended in Vermont. During his State of the State address, Shumlin called on lawmakers to make it easier for Vermonters to get a suspended license reinstated, and to cut the number of reasons a license can be suspended in the first place.

“What was intended to be a deterrent to bad driving behavior should not be a permanent economic disability,” said Christopher Curtis, an attorney with Vermont Legal Aid. “The goal should be not to snare people in a cycle where they get ticket after ticket after ticket after ticket.”

Advocates say traffic fine reforms would reduce economic barriers

Lawmakers are considering legislation that would reinstate driving privileges to thousands of Vermonters whose licenses were suspended due to failure to pay a traffic fine. The legislation would reduce fines for people who are living at the poverty level or who receive state benefits.

Vermont’s system as it currently works is “essentially criminalizing poverty,” Vermont Legal Aid attorney Christopher Curtis told legislators last week.

Fines for minor traffic violations are often out of reach for low-income Vermonters, Curtis said. When one fine goes unpaid, driving privileges are suspended, but that person might continue to drive to get to work and pick up children from school, he said. If caught, the driver is charged with additional violations.

The fines snowball and can run into the hundreds of dollars, creating a barrier for low-income Vermonters who live in rural areas and need car transportation for daily life.

Curtis said he had a client who was sanctioned by the Reach Up program, a benefits program that helps low-income families, because she was unable to get to appointments due to a license suspension.

“You have folks that are trying to meet their obligations, do the right thing, but if their license is suspended they can’t necessarily meet those obligations,” Curtis said.


The legislation also would drastically change the process at the end of the suspension. Reinstatement would be automatic. In the current system, people must reinstate their licenses after the suspension and pay a $71 reinstatement fee, which Curtis said is an additional barrier for low-income Vermonters trying to navigate the system.

Insurers Say Costs Are Climbing as More Enroll Past Health Act Deadline

... Anthony A. Barrueta, a senior vice president at Kaiser Permanente, a large health plan, said the potential for misuse of special enrollment periods “poses a significant threat to the affordability of coverage, and to the viability” of federal and state exchanges.

Consumer advocates said they had not seen evidence of abuse.

“Most consumers are confused by the rules on special enrollment periods and do not understand the system well enough to try to game it,” said Christine Speidel, a lawyer at Vermont Legal Aid. On the other hand, she said, “many people feel that insurance is not affordable, even with subsidies, and they will call the marketplace to see if they qualify for insurance when they get sick.”

Data suggest more lottery buyers are low income

Data released by the Vermont Lottery Commission suggests a link between high lottery ticket sales and areas with higher-than-average poverty levels.

In Vermont, however, people cannot use food stamps to purchase lottery tickets, and according to Chris Curtis, an attorney for Vermont Legal Aid, if a low-income person actually does win money, they could lose their benefits.

 “Vermont benefit programs have very restrictive asset limitations,” said Curtis. He said if a sum is considered large enough and is treated as income, that will knock someone off the program. An applicant has to have less than $2,000 to be eligible.

“Two thousand dollars is the limit for food stamps and for the Reach Up program. That’s not enough nowadays for a down payment for a first month’s rent and security deposit,” said Curtis. Once the asset is brought back down to under $2,000, the person can re-apply for the benefits.

Curtis said that overall the lottery is a bad bet for low-income Vermonters.

“Very low-income people and people living in poverty appear to be being fleeced by the lottery system,” he said. “It does put a disproportionate burden on low-income folks who are unlikely to see any return from the lottery at all.”

Court rejects women’s lawsuit against state

Supporting briefs for a lawsuit filed by three women who said they were getting paid less than a male counterpart to work for the state Department of Corrections were filed by the Vermont Law School on behalf of the Vermont Commission on Women, Vermont Legal Aid, the American Association of University Women of Vermont and the League of Women Voters of Vermont.

The Vermont Supreme Court rejected the suit.

Karen Richards, executive director and legal counsel of the Vermont Human Rights Commission, said Tuesday the commission had joined the complaint to represent the public’s interest in the case. She said the organization was disappointed in the high court’s decision.

“We felt and continue to feel that the case raised an important issue with regard to the manner in which the state salaries are set under their hire-into-range policy,” she said, “and the dangers that creates of creating equal pay issues if the policy isn’t administered in the way that it’s supposed to be.”

Last of settlement money to help with Vermont foreclosures
Vermont Attorney General Bill Sorrell says $190,000 left over from a settlement with Bank of America is going to be given to Vermont Legal Aid and the state's judiciary to assist with home foreclosures.

... the judiciary will use $10,000 to help develop a website for people representing themselves. Legal Aid will use $180,000 to pay for lawyers to represent Vermonters in foreclosure proceedings over the next three years.

Cuts To Reach Up Program Strain Some Of Vermont's Most Vulnerable

VPR tells the stories of Eris Toneatti and Robin Wheeler, who head two Vermont households who aren't sure how they're going to make ends meet with the loss of $125/month from their already below poverty level incomes.

"Christopher Curtis is a staff attorney at Vermont Legal Aid, which filed an unsuccessful bid in federal court to have the cuts rescinded. Curtis says the cuts function as a 'poor tax,' and unfairly target vulnerable families.

“'It’s really the height of irony that anyone could claim that these families are somehow advantaged,' Curtis says. 'First of all, they’re living far below the federal poverty line. Second of all, they have a physical or mental health limitation that precludes them from working.'

"Curtis says the benefit cuts could lead to homelessness and other economic dislocation that will end up costing taxpayers more in the long run. Curtis says with child poverty rates on the rise in Vermont, the state needs to be doing more to combat poverty, not less.

“'It proves that we have got to do more to invest in these programs, so that these kids have a decent start in life and can eventually move to economic independence themselves,' Curtis says."

If you are not part of the solution

Jan Demers, Executive Director of CVOEO (Champlain Office of Economic Opportunity), writes about the 23-page report the Council on Pathways from Poverty submitted to Governor Shumlin in November outlining recommendations to respond to poverty in Vermont.

“'We are not going to end poverty by looking at programs in silos. We are taking a holistic approach to ending poverty by involving state agencies, private non-profits, businesses and private citizens. All areas of state and local government should invest in ending poverty,' said Linda Ryan, Executive Director of Samaritan House in St. Albans, and Chris Curtis, an attorney for Vermont Legal Aid in Montpelier, co-chair the 30 member Pathways from Poverty Council."

“'What motivates this work is a desire to fundamentally change our approach to social and economic justice,' Curtis said. 'We cannot continue to cut our way to prosperity. We need to invest in Vermonters. Many Vermonters find their housing and fuel bills rising while their wages have stagnated or benefits have been slashed. That is a recipe for economic disaster and leaves many families farther behind. Our work is focused on stabilizing and strengthening families in crisis. We know that these investments are prudent, they are effective anti-poverty measures, and they will save public dollars in the long-term.'”


"The Executive Summary focuses on 10 prudent investments which include housing, employment, child care and a potential solution to the Medicaid budget. There is a section on new resources for consideration, citing a $2 occupancy fee on motels and hotels and a cap on Vermont’s pass-through of federal mortgage interest deductions. The last portion of the summary addresses 9 policy initiatives for those experiencing trauma, health, transportation barriers, issues relating to those released from incarceration and housing."