"Howard Dean delivered health care for nearly every child in Vermont and a real prescription drug benefit for seniors who need help."
Medicaid cuts will affect thousands of Vermonters
January 23, 2002
By DAVID MACE
Vermont Press Bureau
MONTPELIER — Tens of thousands of Vermonters would see their state health care benefits rolled back or cut off completely under Gov. Howard Dean’s proposed budget, which seeks to wring $16.5 million in savings from Medicaid.
In an effort to curb costs in a rapidly expanding part of the social services budget, Dean is proposing to require many people who got coverage under his expansions of Medicaid programs to pay for a greater share of their health care.
Medicaid is the state-run program that uses both state and federal money to provide benefits to the poor and disabled. Over the past several years Dean has expanded the programs by allowing participation by Vermonters with incomes higher than the federal guidelines.
Under the proposed budget, about 3,200 elderly or disabled Vermonters who get half the cost of long-term drugs paid for under a program called VScript Expanded would see their benefits disappear. This would save the state nearly $2.5 million. A single Vermonter with an annual income up to $19,332 is currently eligible.
And even those making less who are covered under the state’s standard VScript program will see their costs rise.
Currently, a single person with an income as high as $15,036 is eligible to have all their long-term drugs covered for only a $1 or $2 co-payment.
Under Dean’s proposal, those people — about 3,200 are currently enrolled — would be required to pay half the costs of their drugs, though they would not have to pay more than $750 out of pocket in a year. This would save the state an estimated $800,000.
And Vermonters who get help paying for drugs under the Vermont Health Access Plan, or VHAP Pharmacy, which covers all drugs and requires only a $1 or $2 co-payment, would also have to pay half the cost with a $750 limit.
Currently, about 10,300 people get such assistance, which is available to people with incomes up to $12,888 for a single person. The savings from making them pay half is estimated at nearly $2.7 million.
Finally, some 21,000 residents who get help paying for other medical care under VHAP’s programs would see the services they get reduced and co-payments increased, such as a $250 co-payment for hospital treatment.
All Medicaid patients would see some benefits curtailed because the state would no longer pay for dentures, chiropractic, or podiatry services, and would limit prescription drug choices more severely.
Dean’s plan would also lower the amount the state pays to hospitals for treating Medicaid patients, rolling back an effort by the Legislature last year to beef up the reimbursement level and reduce “cost-shifting.”
That’s what occurs when the state and federal government don’t pay enough to hospitals and doctors to cover the cost of treating patients on Medicaid and Medicare, the health care program for the elderly. Doctors and hospitals must then charge more to patients with insurance coverage, driving up insurance costs.
http://timesargus.nybor.com/Legislature/Story/41169.html People April 18, 2002
Gov. Howard Dean, Visiting Randolph
Predicts Cigarette Tax Will Go Up
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Vermont's legislature will eventually agree to raise the cigarette tax by 67 cents per pack, as he first suggested last year. That was the prediction of Gov. Howard Dean at the Chamber of Commerce breakfast Monday at Vermont Technical College.
In his last appearance as an official guest at a legislative breakfast, Dean also cautioned that even with the major increase in cigarette taxes, the state must also make cuts in the Medicaid program, which is draining state coffers in Vermont and elsewhere.
Dean proposed the cigarette tax increase last year, but it went nowhere. This year he didn't propose a tax increase—but he thinks he'll get one.
The governor admitted that he "never expected" the legislature to accept the deep Medicaid cuts he proposed this year. To offset the cuts, legislators are looking at the cigarette tax increase, with even the Republican House agreeable to a tax in the 35-cent-per-pack area.
Dean predicted, however, that after the Senate weighs in, something like the full 67-cent tax increase will be passed.
Even then, he stressed "we will need cuts anyway, especially in pharmacy benefits."
Passing a big cigarette tax increase and cutting some Medicaid benefits will "supply a cushion" of several years for the Medicaid program, he argued. After those several years, the Medicaid funding shortfall is likely to return, he admitted.
http://www.rherald.com/News/2002/0418/People/p01.html