Health bill unveiled The House Health Care Committee provides first look at this year's health reform legislation

MONTPELIER—The House Health Care Committee, a lot of lobbyists and the Douglas administration all got their first look at this year's health reform legislation Monday, and eyes were popping at the breadth of what was included in the 80-page draft.

The committee came back from town meeting break a day early because it is scheduled to vote on the bill by the end of the week.

The bill would authorize a new insurance product—with a name yet to be decided—that would require those covered to undergo health risk assessments and follow recommendations to improve their health if they wanted to pay the lowest price for the comprehensive coverage. This is a concept that the House Health Care Committee has worked on extensively.

Other sections come from work done in the Senate—such as a ban on the use of artificial trans fats in foods served in restaurants, schools and other licensed food service establishments. This ban would take effect over three years beginning in July of 2010 in chain restaurants.

Susan Besio, who is coordinating the implementation of existing health care reforms for the Douglas administration, sat with a team of health insurance officials Monday afternoon as the legislative panel received a briefing on the new bill.

Her copy had dozens of red tabs signifying questions and concerns that she will speak to the committee about today.

"My main concern about this bill is it contains a lot of different policy directions, many of which hadn't had substantial testimony about the implications," Besio said. She noted provisions altering the way hospital budgets would be reviewed and pages of changes to the rules for contracts between doctors and insurance companies.

Advocates for various organizations also flipped through the bill looking for sections that would impact their clients. Andrea Cohen, public policy coordinator for Vermont Businesses for Social Responsibility, said she welcomed some sections that would push the state closer to publicly financed health care. The bill calls for development of a financial model that could test the feasibility of public financing.

Cohen also cheered the bill's call for development of a plan to merge the small group and individual health insurance markets into a single pool. She wasn't pleased with the proposal to create another new health insurance product, which she worried would fracture rather than pool more of the state's insured.

"We have these long-term goals, and things that move away from those we won't support," she said.

The bill includes several changes to Catamount Health, an insurance program for Vermonters without insurance coverage. One change would prohibit insurance companies offering Catamount plans from excluding coverage of pre-existing pregnancies. The two companies that offer Catamount plans have agreed to cover new enrollees who are pregnant, but lawmakers propose to put the requirement in law.

Lawmakers are looking at even broader coverage of pre-existing conditions and a shorter period of waiting without insurance before someone can sign up for Catamount. These changes would cost money.

Rep. Harry Chen, D-Mendon, said, "I think we need some more discussion of things that cost money in Catamount. Where is that money going to come from?"

Health Care Committee Chairman Steve Maier, D-Middlebury, said the bill proposes several studies and numerous small steps toward a more integrated health care system "to position Vermont as first in line for federal health care reform" once there is a new administration in Washington.

Maier said he sees Vermont as a "perfect laboratory" for future federal health initiatives. "We just need to be as ready for it as we can possibly be."
Contact Nancy Remsen at 229-1298 or