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By Michael Bielawski
As Vermont’s hospitals struggle financially, a bill by the House Healthcare Committee would have the state oversee financial records.
Lawmakers also learned that Vermont’s two health insurance companies are struggling, and Vermonters are paying more for their coverage.
Vermonters paying for expensive loans
“Part of the issue here is Blue Cross [Blue Cross/Blue Shield] is taking out loans at eight percent annual interest to continue operations,” Owen Foster, J.D., chair of the Green Mountain Care Board, said to lawmakers in the House Healthcare Committee on Friday. “So that’s a million and a half dollars a year that ratepayers have to cover so Blue Cross can get those loans.”
MVP Healthcare and Blue Cross/Blue Shield are the two health insurance companies.
Hospitals’ records can be taken
The committee’s bill is 25-0975, which authorizes the Green Mountain Care Board to appoint a ‘hospital observer’ who can collect records regarding their economic stability or lack thereof. They would “oversee a hospital and its operations if the Board finds the hospital has made a material misrepresentation or is out of compliance with its budget and the Board believes that appointing an independent observer is in the public interest,” and the hospital would pay for it.
It states, “The Board may order a hospital to pay for all or a portion of the costs of an independent observer appointed for the hospital pursuant to this subdivision.”
The Board would then be able to make recommendations on how the hospital can adapt to get out of financial trouble.
It says that the observer will “monitor the hospital’s operations, obtain information from the hospital, and report findings and recommendations to the Board.”
Not forcing closures
In the past, the Board has been adamant that they won’t force hospitals to close against a community’s will. Foster said in a press release back in November, “The Oliver Wyman report does not mandate any changes at any Vermont hospital. Rather, it provides a projection of Vermont’s financial headwinds and provides options for local communities and hospital leaders to consider.”
On Friday, Foster spoke to lawmakers on the urgency that at least four hospitals are facing. He identified the Brattleboro, Grace, Giffords, and Springfield hospitals as being in “acute financial distress.”
The Committee’s chair, Rep. Alyssa Black, D-Essex, suggested that this bill would be meant as a last resort measure for struggling hospitals.
“This is a short-term, I would call, emergent authority for what is right now in this moment a dire circumstance. And we could discuss for hours how we got to this, but regardless, we’re here,” Black said.
Some communities have pushed back against suggestions for a closure. Newport Mayor Linda Sullivan wrote in a report in September of 2024, “I can’t think of anything that would more discourage the investors and development we are trying to attract to the region than to have the State communicate that we so little value the communities in this remote and isolated part of the State that we are as a State going to just gut our health care infrastructure here.”
Loss of services?
Foster told the committee, “Our healthcare system is at a true inflection point with immediate risk of loss of services and loss of coverage of insurance. One of them is domiciled here and it’s having acute financial distress. If the insurer has an inability to pay claims or cannot remain in the QHP [Qualified Healthcare Plan] market in 2026, there’s a very high risk that the other insurer from New York leaves the market.”
He suggested that if these companies leave, then “70,000-plus Verrmonters cannot get health insurance.”
“Devasting to public health”
Foster said, “There would be no small group, means your restaurants, your creamy stands, your nonprofits, your FQHCs, your small independent practices may not have an option to buy health care insurance for their employees. That is devastating to public health.”
There is currently no law requiring people to purchase health insurance. Citizens without insurance default to a pay-per-visit model with billing adjusted to their income, commonly known as Charity Care.
Foster said that the insolvency of these companies “really jeopardizes the sustainability of the entirety of the healthcare system.” He added, “This bill would allow the care board in those extraordinary circumstances to lower the prices of particular hospitals to protect from that event happening. So the metrics here are a 125 days cash on hand, and a positive operating margin.”
This observer could access information regarding whole hospital networks, such as UVM Medical Center, which has five campuses. The observer could ask for “any information regarding the hospital’s participation in a hospital network.”
Foster told the committee, “This will not fix Vermont’s health care problems,” but he did say, “It will really help get us where we have more time to fix the system because we haven’t lost the insurer.”
On Monday, Black told VDC that the committee bill is still in the drafting stage and it will reappear soon in a more traditional bill form.
Reach out to your lawmakers
See all bills assigned to this committee here. Constituents may contact committee members (click link on name for bio, party affiliation, etc.) with comments, questions, and information at the following email addresses:
House Healthcare
Rep. Alyssa Black, Chair, ablack@leg.state.vt.us
Rep. Francis McFaun, Vice Chair, fmcfaun@leg.state.vt.us
Rep. Daisy Berbeco, Ranking Member, dberbeco@leg.state.vt.us
Rep. Brian Cina, bcina@leg.state.vt.us
Rep. Mari Cordes, Clerk, mcordes@leg.state.vt.us
Rep. Wendy Critchlow, wcritchlow@leg.state.vt.us
Rep. Allen “Penny” Demar, ademar@leg.state.vt.us
Rep. Leslie Goldman, lgoldman@leg.state.vt.us
Rep. Lori Houghton, LHoughton@leg.state.vt.us
Rep. Woodman Page, wpage@leg.state.vt.us
Rep. Debra Powers, dpowers@leg.state.vt.us
All committee transcripts are available at http://www.goldendomevt.com. The Committee meeting video is available at the committee’s YouTube channel. The committee meets in the morning in Room 42.
The author is a writer for the Vermont Daily Chronicle
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Categories: Health Care, Legislation, State Government
Waiting for the law requiring people to buy health insurance. With this inflation that is putting more people into poverty, I have a feeling this idea will not be popular. You already paid into Medicare and some insurance companies have control over these funds. This is beginning to look like a taxpayer bailout for the health care industry and insurance companies.
HC 911 has recently publicized the extreme Administrative costs at UVMMC. I am wondering if GMCB plans to address that issue. Reducing at least some of that might help reduce at least some of the ins. costs. Just saying.
And now………… Where’s the rest of the story?? So you tell us Blue Cross- Blue Shield is taking out loans and passing the interest onto ratepayers…… Sooooo what’s being done about it????
Going into the lending market!
What a mess! And I honestly don’t understand how both insurance companies and hospitals are running in the red. Yes, add an observer under GMCB and bill the hospitals for that state employee. Increasing bureaucracy has always proven to be effective. Pay-per-visit and expanding the market with more companies and catastrophic care-only insurance policy options.
Health insurance has become a worthless product. High costs and high deductibles have reached the end of what people can afford. Health care benefits are too expensive for businesses and taxpayers. Our health care system is in crisis and this bill will only postpone the inevitable. It will not help in any way. It is clear the health insurance companies, the medical establishment, the GMCB, and the legislature don’t know how to fix the situation. It seems they all know how to line their own pockets while leaving Vermonters to foot the bill . If 70,000 Vermonters lose their health insurance it might be the best thing to happen. People can pay for their own medical care by using the money they save by not having deductibles and health insurance costs. If their costs are more than they can afford they can get so called charity care, or they can get a lien on their house or they can go bankrupt. Does this sound heartless? Well it is what some Vermonters are facing. All while administrators are getting high salaries. Do not expect the people who caused all this to fix it.
No different than our education system healthcare was pretty decent until politicians got involved. Until we remove them and let free markets work nothing will change.
FRAUD – COLLUSION – CORRUPTION
Let’s review some history to show there is no honor among thieves:
VTDigger April 6, 2017: “Members of the Green Mountain Care Board raised questions Tuesday about growth at the University of Vermont Health Network.
The board, which regulates hospital budgets and health insurance prices, brought up several concerns while three hospital finance officials explained why the network took in $41.5 million more in fiscal year 2016 than they budgeted. The UVM Health Network started in 2011 under the name Fletcher Allen Partners. It was designed to be an umbrella organization for what are now the UVM Medical Center and the Central Vermont Medical Center. The network has grown substantially since 2011. The UVM Health Network now controls three hospitals in upstate New York, and will control Porter Medical Center in Middlebury by the end of the month.”
VTDigger September 10, 2017: “The chief financial officer for the University of Vermont Health Network is backtracking on recent statements about whether the network’s flagship hospital transfers money to hospitals in New York. Todd Keating said in an email last week that the University of Vermont Medical Center makes cash transfers to smaller hospitals within its network and has made a $7.5 million transfer to a hospital in New York that covered a budget shortfall. Keating made the comments a week after he gave an interview to VTDigger in which he said categorically that the Vermont hospitals do not subsidize the New York hospitals.
The UVM Health Network is the largest hospital system in the state and has three hospitals in upstate New York and three hospitals in Vermont. While the Vermont hospitals have repeatedly taken in more revenue than budgeted and have run surpluses in recent years, two of the three New York hospitals together have lost more than $25 million since fiscal year 2013, according to financial information provided by the UVM Health Network.”
VTDigger January 8, 2018: “State regulators have approved a $151.7 million project aimed at modernizing and streamlining electronic medical records systems at four University of Vermont Health Network hospitals. The Green Mountain Care Board found that the upgrade – in which a new unified system will replace a patchwork of older systems – will simplify patient record-keeping, decrease the chance of medical errors and reduce security risks. The board’s Jan. 5 decision also says the project won’t hurt UVM Health Network’s services or finances. The board hired its own financial adviser to evaluate the health network’s proposal. “Our consultant has confirmed that the applicant is financially strong and has sufficient capacity to pay for the project, even if it does not realize all of its projected financial targets,” board members wrote. The health network plans to pay for the project in part through employment reductions and efficiencies.”
VTDigger May 30, 2018: “State health care regulators have approved a $22.1 million property purchase by University of Vermont Medical Center in South Burlington.
Hospital administrators had sought permission to buy two Tilley Drive buildings that UVM Medical Center currently occupies and leases from a private owner. The transaction, administrators say, will save tens of millions of dollars in the long run.
Green Mountain Care Board members agree, saying the transaction “will not unduly increase the costs of care” in northwestern Vermont. “To the contrary, the savings associated with the project represent a financial benefit to the public by freeing up funds that would have gone to lease payments and reinvesting the savings in patient care and quality improvement initiatives,” care board members wrote.”The U.S. Attorney’s Office has declined to intervene in a case alleging that OneCare Vermont has committed fraud.
VTDigger November 27, 2019: “Robert Hoffman, a former manager of the analytics team for OneCare, asserted that the accountable care organization and the University of Vermont Medical Center had misled the state and federal agencies about the reliability of its data, which is central to the state’s health care reform efforts.
Hoffman claimed the government, specifically the federal Center for Medicaid and Medicare Services, had been defrauded and that he was fired from his job at OneCare because of the concerns he raised. U.S. Attorney Christina Nolan declined to intervene in the case and made the court documents public on Wednesday. Nolan didn’t say why she made the decision, and she did not immediately respond to requests for comment. Hoffman filed the complaint with the U.S. Attorney’s office in August 2018. He accused OneCare of violating the False Claims Act, which allows a whistleblower to come forward if they see a company commit fraud and if they believe it is costing the government money.”
VTDigger December 9, 2019: “State Auditor Doug Hoffer says a whistleblower’s claims that OneCare Vermont misled regulators are a “big deal” that should be investigated. Hoffer said he’d “absolutely” look into the allegations made by Robert Hoffman, who formerly managed the data analytics team for OneCare Vermont — if Hoffman doesn’t move forward in court on his own. Hoffman alleged in a False Claims Act case filed with the U.S. Attorney’s office that OneCare, a private company, claimed systems for analyzing patient information were reliable, even though they were aware that the data had serious deficiencies. Those claims led the state and feds to continue investing in the technology.While the auditor has shown interest in reviewing Hoffman’s claims, other state officials expressed little interest in pursuing the issue. Several people, including health care regulators, declined to comment. Most felt the judicial system was the proper venue to vet the allegations.
“We take all allegations of this nature seriously,” said Rebecca Kelley, a spokesperson for Gov. Phil Scott. She said she was confident that the feds and state had done a comprehensive investigation. “We have faith in their thoroughness — and in the work the accountable care organization is doing with Medicaid — and do not see a reason to launch a third investigation at this time,” she said. Attorney General TJ Donovan said his office was satisfied with the work of his federal counterpart and decided that his own investigation would be unnecessary. “
Who are you? I live across the street form UVMMC and am in the process of stopping them from tearing down the McClure garage. Why isn’t something being done about One Care?
Any business who is directly tied to the hospital industry must left to die on it’s own and not assisted by this Criminal Fascist nazi State. WHY?
I’ll gladly tell you why the entire Fake Covid GENOCIDE OPERATION involved The State of Vermont and it’s AGENCIES, legislators, Medical clinics, Hospitals Sheriffs ( sheriffs by not stepping in) and the vast mass of Doctors.. These business aseptically the medical made a bundle of money from medicare by false diagnosis and then using deadly drug taken, for a long time off the market because of deaths, and that drug was Remdesivir. This drug was used prior to putting this poor patients onto the ventilator and bingo their are dead in a few days. Next patient please and the Nurse’s knew what was going.
Every person who is a doctor and came up with a COVID diagnosis, the ECO of every Hospital who directed this to take place, anyone in this chain must be prosecuted by the fullest extent of MILITARY LAW. FOLKS we have been under soft Military Law since 2020 and we also have a totally corrupt and criminal Judicial court system . A Military Tribunal is the only venue in which Equal justice can be served. These Criminals killed for money thousands and Millions of citizens with fake diagnoses. This is my opinion based upon reports surfacing by Medical doctors with international reputations. The national media was also part of this global operation
Where will the White Knight come from?
We know its not the VTGOPers, they’re incapable of putting together a simple plan to cut spending and taxes.
Hey, VT GOP-
Wanna become relevant, do some good? Use this as the first case for the VT DOGE Team. You can reach out to the friendly Republican White House for guidance for staffing and implementation…. Oh never mind.