Committee begins review on Vermont’s health care budget

By Dave Fidlin | The Center Square

Medicaid, emergency medical services and mental health were among the weighty funding priorities a Vermont legislative panel began digging into Monday in a comb-through of Gov. Phil Scott’s fiscal year 2024 budget.

The House Committee on Appropriations began its review of the state’s health care budget for the upcoming fiscal year, which begins in June. The panel’s deliberations come on the heels of a mark-up from members of the House Committee on Health Care.

State Rep. Lori Houghton, D-Montpelier, who chairs the health care panel, provided the Committee on Appropriations an overview of the forwarded recommendations.

The Committee on Health Care added additional appropriations into Scott’s preliminary draft version of the budget. All told, the proposed additions would require $9.5 million in state funding and, in turn, would draw down an additional $10 million in federal funds.

Houghton said the Committee on Health Care also ranked its recommendation by priority level, with Medicaid rates taking the top spot.

“We have underfunded Medicaid for years,” Houghton said. “When we pay providers less for the true cost of the service to deliver care, we’re just discouraging them from providing those services.”

The committee is supportive of Scott’s recommendation to increase reimbursement levels for primary care providers and offer up a 3.8% inflation increase to specialty care providers.

The proposal is expected to cost $1.75 million for primary care providers and $3.8 million for specialty care providers.

Houghton and the Committee on Appropriations also discussed another aspect of health care that has been deemed chronically underfunded: EMS. Emergency medical services ranked second on the Committee on Health Care’s priority list.

Upping Medicare reimbursement rates to 100% from the current 70% rate is expected to cost $3.11 million in the agency’s overall budget.

The rate increase, Houghton said, will help EMS providers “dig a little bit out of the hole” from years of underfunding.

“This is the most basic,” Houghton said. “Somebody needs to be able to call 911 and have an ambulance come.”

The Committee on Health Care also supported Scott’s proposed earmark of $3.35 million in funds and grant appropriations for a mobile crisis response system linked to mental health treatment, which has been on the rise since the onset of COVID-19.

The mobile crisis response system, Houghton said, would provide Vermonters with a more immediate deployment of services. The program also is aimed at bringing different factions of government together.

“We need to be working our schools more,” Houghton said, pointing to one example. “It is a multi-faceted process that we need to invest in.”

The Committee on Health Care made a number of recommendations that ran counter to Scott’s budget proposal.

For example, the committee is recommending against changes to the drug coverage benefits for the Department of Vermont Health Access program. The maneuver increases the budget by $1.74 million.

“If this Medicaid benefit goes away, Vermonters will either be moved to costlier prescription drugs or will not be able to afford drugs to treat allergies and other ailments,” Houghton said. “This ‘cost saving’ measure will only cause Vermonters to seek higher-cost care.”

State Rep. Diane Lanpher, D-Vergennes, is chair of the Committee on Appropriations. She said the Committee on Health Care’s recommendation will be weighed as deliberations within her panel get underway.

“We’re going to be making some big decisions,” Lanpher said.

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