Vermont lawmakers unveil universal primary care proposal

February 12, 2015

A group of lawmakers introduced a bill that would publicly finance universal access to primary care services in Vermont by creating a dedicated Universal Primary Care Fund to make capitated payments to providers covering primary care for all Vermont residents. The idea for the bill came from Dr. Deb Richter, a family medicine doctor and advocate for universal healthcare who said she wanted to fill the vacuum created after Gov. Peter Shumlin decided not to pursue single-payer. Richter says a universal primary care system will hold down costs because it will enable patients to better manage chronic conditions and avoid costly hospitalizations. Under the proposal, Medicare and Medicaid would continue to be first payor for primary care services for their beneficiaries, but the primary care program would cover any out-of-pocket expenses. The plan design of private insurance could remain the same, Richter said, but insurers would no longer need to pay claims for primary care services which would allow them to reduce premiums by as much as 8%, she said. The bill requires the legislative Joint Fiscal office to calculate the costs of the program before Dec. 15, and identify possible revenue sources to pay for it. An appropriation to pay for it would then occur in "early fiscal year 2017," according to the bill's language. It also directs the Agency of Administration to begin negotiations with the federal HHS to obtain a waiver to the ACA to allow the program to go forward, and explore the need for a Medicaid waiver as well. The program's anticipated launch date would be January 2017; the earliest states can obtain a waiver to the ACA. A companion bill in the Senate is now before the Senate Health and Welfare Committee.