10-9-14 – Seniors, Medicare & Single Payer

posted by Rob Roper

An interesting kerfuffle popped up in the comment pages of Vermont Digger’s recent article, Feliciano Claims Shumlin Wants to Take Over Medicare. First, the way the headline is phrased is meant to cast doubt on the “claim.” However, Act 48 as passed – which Shumlin signed and his party and the Progressives wrote and voted for – spells out specifically that the Vermont does in fact want to take over Medicare. It states with emphasis added:

“The director, in collaboration with the agency of human services, SHALL obtain waivers, exemptions, agreements, legislation, or a combination thereof to ensure that, to the extent possible under federal law, ALL FEDERAL PAYMENTS PROVIDED WITHIN THE STATE FOR HEALTH SERVICES ARE PAID DIRECTLY TO GREEN MOUNTAIN CARE. GREEN MOUNTAIN CARE SHALL ASSUME RESPONSIBILITY FOR THE BENEFITS AND SERVICES PREVIOUSLY PAID FOR BY the federal programs, including Medicaid, MEDICARE, and, after implementation, the Vermont health benefit exchange.” (Page 12)

And,

“The agency SHALL SEEK PERMISSION from the Centers for Medicare and Medicaid Services TO BE THE ADMINISTRATOR FOR THE MEDICARE PROGRAM IN VERMONT.” (Page 85)

Digger reporter Morgan True pointed out that Act 48 has since been refined to read,

(e) The Agency SHALL SEEK PERMISSION from the Centers for Medicare and Medicaid Services TO BE THE ADMINISTRATOR OF THE MEDICARE PROGRAM IN VERMONT. If the Agency is unsuccessful in obtaining such permission, Green Mountain Care shall be the secondary payer with respect to any health service that may be covered in whole or in part by Title XVIII of the Social Security Act (Medicare).

The new language reflects the reality that Shumlin et al may not get what they want from the feds, but it’s not a “claim” by Feliciano that the governor and the legislature WANT to take over Medicare. It’s a fact codified in law. And, they are legally obligated to try.

Whether successful or not, seniors will be impacted by the transition to single payer should it occur. If Vermont gets its waivers, Medicare will be folded into Green Mountain Care. If not, then GMC will become the secondary or “wrap around” payer. This means that seniors who have private wrap around or Medigap policies could potentially no longer be able to obtain them. GMC will fill that role; how well, who knows? All we know for sure is that the program will be administered by the same people who brought us the Vermont Health Connect debacle. Not comforting.

Many commenters on the Digger article accused Feliciano of trying to scare seniors. But, these are facts. If the facts are scary, we have a problem.

– Rob Roper is president of the Ethan Allen Institute www.ethanallen.org

{ 11 comments… read them below or add one }

Ivan Smith October 9, 2014 at 10:03 pm

I see the FUD campaign is well under way. Remember what I said about an honest conversation? Am I the only person that writes in these most of the time? How many people actually reads your crap???

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D. Smith October 9, 2014 at 10:47 pm

Ivan, If you disagree with what has been posted tell us why. Then we can agree, or disagree with you and have an intellectual debate. Otherwise you come across as a trouble making internet troll. Your snarky comments add nothing to the subject matter being covered.

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Larry Jensen October 10, 2014 at 1:07 pm

if the State does not capture Medicare Payments they have a major financial shortfall. Also, the section of the law shown would indicate that the State intends to take over Medicare supplementary plans also.

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Wendy Wilton October 22, 2014 at 12:10 pm

Agreed. Even early on this was a question for Anya Radar Wallack and she responded that GMC would be the Medigap option.

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John Sheppard October 10, 2014 at 2:11 pm

Rob, this is fairly interesting stuff. I would then wonder just who the State or who GMC would hire to do all the work and administrate their plan? Probably BC/BS or MVP? Will people not be able to get “wrap around insurance”? And how would that differ from what we have right now?

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Rob October 10, 2014 at 2:46 pm

Hi John, Yes, I believe the that BC/BS will be the sole administrator of GMC. What happens to MVP, I don’t know. I think we need to have a big conversation about supplemental insurance, not just for medicare folks but for everybody. It hasn’t been addressed at all, and has the potential to add tens of millions to a hundred million in healthcare costs.

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jim bulmer October 10, 2014 at 9:05 pm

One more reason to seriously consider moving on. Vermont is becoming too much of a finacial burden on seniors. Can not understand what motivates these people. I’m told that stupidity or insanity, can’t rember which, is doing the same dumb thing time after time and expecting a different result.

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Mike Powers October 11, 2014 at 5:03 pm

Another example of the Shumlin’s desire to take away choice and replace it with a governmental mandate. Medicare is and has been a mainstay of senior medical insurance for decades. Now we are presented with the possibility that the tiny state of Vt. can administer a better plan? This is nothing but the states blatant grab for the Medicare premiums to help fund the Vt. Single Payor plan. The state has spent over $70,000,000 on the defunct exchange. Are we willing to stand by and let them totally screw up the delivery of medical services to our seniors? Wake up Vermonters. Don’t let this happen. The eventual ramifications of this blatant power grab are incaluable. Write or call your state representatives and let them know you are opposed to the State’s takeover of Medicare.

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filia libertatis October 14, 2014 at 6:32 pm

My MVP insurance is cancelled as of 11/30- and when I called to find out the new restrictions, I found it will no longer be able to authorize medical treatments outside of Vermont or NY state. Given the amount of Vermonters who go to Dartmouth Hitchcock, or Boston for medical care, this forces us into BCBS- a de facto single payer. I do not trust the system Shumlin is setting up, and I do not trust the roll out.

I have a pre-existing condition, and a fierce medical team at Mass General that I will not surrender or risk not being covered for. I have rented a house in MA, and will be moving there in a few weeks, enrolling in Romney Care. I predict I am part of a first wave of “medical migration”, where people who can will move to the areas that serve their medical needs best.

I am a home owner, tax payer, community volunteer, a good and productive citizen, and VT has lost me, and I her. I believe I have to to leave, in order to literally stay alive. Is this cost effective for either of us? I doubt it.

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Peg October 16, 2014 at 5:41 pm

1984? Animal Farm coming to VT?

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AK October 18, 2014 at 5:27 am

Ladies and Gentlemen,

You are being fleeced. The fee-for-service, virtually unlimited choice, no treatment withheld Medicare that you have paid into your whole life is being stolen from you and being replaced with an HMO. That’s right, an HMO. Worse yet, it is a singular HMO with no competition in state to keep it somewhat honest. Worser yet, an HMO with omnipotence as it controls every single healthcare dollar and is able to bully health providers into what they should and should not give you.

And why? So it can shunt money from you to give to others and provide them with “free” and equally cruddy healthcare. Stand up to these people and get the benefits, freedom and choice that you have already paid for.

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