The Senate Finance Committee is considering a drastically pared version of Sen. Peter Galbraith's single-payer financing bill - one that doesn't include a financing mechanism.
"One of our goals this year, and we've talked about this before, is to start advancing some decision-making on various aspects of health care reform," said Sen. Tim Ashe, P/D-Chittenden, chair of Senate Finance.
While a financing plan is important, it's not the only policy question lawmakers must answer as part of Vermont's reform efforts, he said.
The Shumlin administration is planning to announce this spring several financing options for Green Mountain Care, the state's planned universal health care program. It's expected that the Legislature will vote on a financing plan and benefits package for the program during the next biennium.
The committee is considering a strike-all amendment to Galbraith's Green Mountain Care financing bill, S.252, which caused a stir earlier in the session as the first concrete proposal to pay for universal health care. Among other things, the plan included a payroll tax.
The only portion of S.252 that's recognizable from Galbraith's initial offering is the provision keeping federal employees and military personnel on their federal health coverage, while giving them the option to pay into Green Mountain Care for secondary coverage.
The most noteworthy change the bill makes is giving Medicare beneficiaries the same choice.
Sen. Kevin Mullin, R-Rutland, said by not automatically providing secondary or wrap coverage to seniors would hurt Medicare beneficiaries.
A recent poll on health care reform conducted by the National Education Association - which recently jumped into the push for single-payer - found that 88 percent of respondents favored allowing seniors to keep Medicare as their primary coverage and allowing Green Mountain Care to supplement that coverage.
The bill would do that, but require them to pay for their supplemental coverage, which most already do.
Robin Lunge, commissioner of Health Care Reform, said the administration doesn't have a position on the new bill, but said it would affect coverage for Medicare beneficiaries who have their coverage publicly supplemented.
The rewritten S.252 also adds timing elements for the transition to Green Mountain Care that are currently undefined.
It would require the Agency of Human Services to tell lawmakers what aspects of the program's administration would be contracted out - such as claims administration and provider relations - by January 2015 and award those contracts the following year.
The bill would also add obesity and mental conditions to the list of chronic conditions in the Blueprint for Health, and expands the program's compensation to providers.
Galbraith urged the committee to reinsert a set of guiding principles for developing a financing plan included in his original legislation.
"I think it's useful guidance," he said.