Seniors, Medicare and single payer

Dear Editor,

An interesting kerfuffle popped up in the comment section of VermontDigger.com’s recent article, “Feliciano claims Shumlin wants to take over Medicare” (see reprinted article, this issue). First, some thought the way the headline was phrased 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 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.”

And further:

“The agency shall seek permission from the Centers for Medicare and Medicaid Services to be the administrator for the Medicare program in Vermont.”

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. Feliciano’s claim that the governor and the legislature want to take over Medicare is a fact now codified in law. And they are legally obligated to apply.

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, president

Ethan Allen Institute

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