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Key Issues
Governor Shumlin delivered his last budget proposal to the Legislature Thursday afternoon. The plan calls for a 3 percent increase in spending and raises roughly $30 million in new taxes. This - he said - is his first budget that's not balanced by the use of money available for only one year. State spending will be based on ongoing revenue. In the past year, roughly 20,000 Vermonters signed up for the expanded Medicaid program and the state didn't have the money to cover the new costs [see "Budget Adjustment" below]. Shumlin wants to expand an existing health care provider tax to include independent doctors and all dentists. Hospitals and physicians employed by the hospitals already pay this tax. He also proposed a $10 million package to hire 35 new workers at the Department for Children and Families, and called for an additional opiate treatment hub in the northwestern part of the state. That hub could treat an additional 400 people.
Budget Adjustment
The Budget Adjustment bill has left House Appropriations. $67.4 million in a Medicaid gap was the largest part of the mid-year adjustment. To bridge that gap the committee and administration used $10 million from the General Fund, $10.3 million in one-time money from the state health care resources fund and $47 million in federal funds. The Affordable Care Act has expanded Medicaid to insure Vermonters who were previously uninsured. The increased cost is largely driven by the fact that a third of the state's population - about 200,000 - are on Medicaid. The committee closed an additional gap of $10 million in state spending by raising revenues from a variety of funds.
Marijuana Legalization
With the exception of general budget issues this is the talk of the State House. The testimony during the last week has been on the Senate side, where the bills on this issue are starting. Both Senate Judiciary and Health and Welfare heard testimony. The general sense is that the bill coming out of Government Operations has a reasonable chance of passing in the Senate. It's future in the House is a source of endless speculation.
Group Therapy Reimbursement
An issue we have been following closely is the reimbursement rate for patients in group therapy, rates that have dropped from about $40 to around $15 per patient per session. Advocates argue strenuously that this is a rate that will make it impossible for designated mental health agencies to provide the service, a service which they argue makes both clinical and financial sense. An attempt to backfill the money to cover the loss failed in the Budget Adjustment bill in House Appropriations. Advocates claim that more clients will be bumped to one-on-one treatment, treatment that they believe will be more expensive, less clinically effective and will increase costs.
Reach Up Funding
A Wednesday press conference focused on the cuts to the Reach Up program. The reductions kicked in last month, and they hit disabled Vermonters eligible for a federal program called Supplemental Security Income. Annual benefits for about 860 households will go down about $1,500 per year. Legislators said that though they appreciate the advocates' concerns, fiscal pressures would make it difficult to find the revenue needed to backfill the cuts. Ed Paquin - Director of Disability Rights Vermont - pointed out that if that if property taxes for average Vermonters went up $1500 there would be an explosive reaction - an apt parallel.
Problem Gambling
In 2015, the Legislature changed it's funding approach for the state's problem gambling awareness, treatment, and recovery resources. Previously, the funding went to the oversight of addiction and recovery experts. Now, the funding goes directly to the Vermont State Lottery to use as it chooses to support problem gambling efforts. This is obviously the fox guarding the henhouse. The Vermont Council on Problem Gambling seeks the reinstatement of its annual $150,000 appropriation directly from the legislature.
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