MONTPELIER -- How should Vermont raise the roughly $2 billion necessary to pay for its planned first-in-the-nation universal publicly financed health care program?
For the public, that question no longer has to be rhetorical.
Vermont Businesses for Social Responsibility recently released an online calculator that allows users to levy their own combination of taxes to generate the money to pay for Green Mountain Care, as the program is called.
The tool works by placing the state's largest revenue generating taxes - as well as a sugar and carbon tax - on sliders that default to current rates and lets the user adjust them to design their own tax structure.
The nonprofit trade organization created the calculator to gather input from its members that it will use to develop policy recommendations to push in the Legislature next session, when lawmakers must hammer out the details of a financing plan, said Dan Barlow, public policy manager for VBSR.
"We know this is going to be a big issue in the Legislature next year," Barlow said, "so we wanted to get the conversation started with our members."
The calculator is simple and easy to use, so VBSR decided to make it available to the public.
"I think this is a little bit of tax education," Barlow said, because it focuses the discussion on taxes that could reasonably generate the $2 billion to get the program off the ground, and dispels the notion that Vermont could fund universal coverage through something like a tax on sugary beverages.
Robin Lunge, director of Health Care Reform for the Shumlin administration, said she appreciates VBSR furthering the conversation around health care financing.
But for Lunge, who is helping to lead the team that is designing the governor's financing proposal, the calculator is a little too straightforward, she said.
"For members of the public there could be some simplicity to it," Lunge said. "I think it's important to recognize, and I don't think this comes across with the calculator, that this is money that's already being paid in premiums."
There is an introduction on the calculator Web page that informs users that Vermonters already pay $2 billion in premiums and close to $5 billion on health care.
But it doesn't show the user how their taxes already pay for health care, and while one of VBSR's business members might go into the exercise aware of what they pay in payroll taxes and what they pay toward employee health coverage, they might not have as clear a sense of how other taxes they pay currently go toward health care, Lunge said.
For example, property taxes help to pay for the health care of teachers and municipal workers, while income and other taxes that feed the General Fund help pay for state employee health care.
The tool doesn't allow business owners or members of the public to input their health care spending or what they pay in taxes to see how adjusting the sliders would affect those costs, Lunge said.
Such a calculator would likely be tremendously more difficult to develop. That, in itself, reveals the complexity of what the state is trying to do.