Those who don’t have a policy either through the exchange or with an employer will have to pick a plan from the health care exchange by Saturday to have it go into effect April 1. Miss the date, and health care coverage may not be available until later this year.
Note that we used the words “may not be available” with purpose. After all, no one really knows how absolute those March 15/April 1 deadlines really are. Deadlines have been constantly shifting with the health care exchange. There’s nothing to say that they won’t be moved again, or that after April 1 individuals will still be able to sign up. But at this point, that doesn’t appear to be the case.
The one deadline we do know will not be met is the one put in place by the governor and the administration to lay out how the state will finance the planned single-payer health care system, slated to go live in 2017.
Gov. Peter Shumlin said as much on Monday, acknowledging the administration “just isn’t ready” to reveal financing plans. While delays may be par for the course when it comes to health care reform deadlines, it also seems a little disingenuous that the administration is saying it can’t deliver even a rough outline of how they plan to fund a single-payer system in Vermont.
We know the Legislature and the governor are trying to fix the rising costs of health care and how to pay those costs.
But we also know that an honest discussion about how the money will be generated to fund any kind of single-payer plan is a critical component.
In our opinion it’s important to start that discussion now, while there is still time to hash out plans, instead of waiting another year or two, then ramming something through the Legislature at the last minute. We’ve seen that happen time and time again, often with significant unintended consequences.
Seventeen years ago, the Legislature and then-governor Howard Dean were in a scramble to develop and pass a new system for funding education in Vermont. Out of that scramble, drive by a state supreme court ruling in the Brigham case that required “substantially equal” access to education for all Vermont students, the Legislature came up with Act 60. Six years later, after the flaws of Act 60 were exposed, education funding was modified under Act 68. Neither plan was even close to perfect, and we are now seeing the limitations of Act 68 playing out across the state, and once again many are calling for change to how we fund education.
We urge the governor and state legislators to use the history of education funding to help guide them through the process of health care reform. There are some valuable lessons to be learned.
A full public airing, with time for analysis, debate, and perhaps some new idea that hasn’t been thought of, will lead to a better, more sustainable system.
Defining what to pay for, eliminating waste, and gauging outcomes are all important factors, and ones that have not been incorporated very well into our education funding system.
Funding an education system will look like a drop in the bucket compared to reinventing Vermont’s health care system into a single-payer plan.
It’s imperative to get it right. And that might take some creative thinking, which is not always government’s best quality.
Which is why we are very disappointed that the governor and his administration won’t begin the discussion of how to pay for a single-payer system. If Vermont has learned anything from its experience with statewide education funding, it should be that it’s much easier to dissect a plan before it becomes law, instead of waiting for the other shoe to drop after it is enacted.
If legislators won’t hold the administration accountable to its own deadlines, voters certainly should.