May 24, 2019

Scott administration opposes universal primary care

By Mike Faher

For VTDigger

Gov. Phil Scott’s administration is taking a firm stance against a legislative effort to create a universal primary health care system.

The administration is opposed to S.53 in part because publicly financed primary care would require new taxes. But that’s only one of several problems, said Michael Costa, deputy commissioner of the Department of Vermont Health Access.

Costa also says universal primary care doesn’t directly address the high cost of health care, which is the administration’s top reform priority. And he’s concerned about possible conflicts with the state’s ongoing efforts to switch to a new system of payment for medical providers.

“How much reform can you responsibly manage?” Costa asked. “I think to take on a totally separate, second statewide reform effort will put both projects at risk, for uncertain benefit.”

There has been a strong push for universal, publicly financed primary care during the 2018 legislative session.

Supporters packed the House chamber for a January hearing on the matter. And in early March, the Senate Health and Welfare Committee approved a version of S.53 proposing that the state work toward a publicly financed primary care system with no patient cost-sharing.

The Senate eventually approved a weakened version of that bill that has no commitment to taxpayer financing.

S.53 is now in the House, where the Health Care Committee last week heard from consistent universal primary care supporters like Vermont Businesses for Social Responsibility; Dr. Allan Ramsay, a former Green Mountain Care Board member; and Dr. Susan Leigh Deppe, representing the Vermont Psychiatric Association.

Deppe made an argument heard often in this year’s debate: Increasing access to primary care will decrease the cost of health care in the long run by focusing resources on preventive care and early interventions.

“This isn’t about money or taxes,” Deppe said. “This is an investment … and we’re already spending the money. We need to think of it that way.”

Costa told the committee that the Scott administration supports investing in primary care. He also expressed support for the goal of “everybody having health insurance,” pointing to the administration’s backing of a state individual mandate bill earlier this session.

But he doesn’t think the current push for universal primary care is the way to reach that goal.

Financial concerns play a role in the administration’s position. If a new primary care system is publicly financed, it will rely heavily on revenue from some still-unspecified tax.

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