Vermont lawmakers approve health care rules
By BETH GARBITELLI
The Associated Press | July 11,2014
MONTPELIER — A legislative panel Thursday approved a lengthy set of provisions governing health care after Vermont Legal Aid withdrew its objections.
The Legislative Committee on Administrative Rules approved the set of provisions on health benefits eligibility and enrollment as part of wider efforts to reform health care in the state, a major goal for Gov. Peter Shumlin and legislators.
The rules do not require approval by the full Legislature.
“This is implementing key requirements of the Affordable Care Act,” said Selina Hickman, the policy director for Vermont Health Access. “It also represents an effort to consolidate and streamline Medicaid and Vermont Health Connect eligibility processes as we move toward Green Mountain Care under Act 48.”
Vermont Legal Aid had initially objected that one section, as written, might exclude certain populations from long-term care benefits in a Medicaid-funded program called Choices for Care. It offers benefits for long-term care and is designed to assist people who require intensive assistance.
The profile of the person whom they believed might be affected is very specific: above the poverty threshold, younger than 65, not disabled or blind or pregnant, and without dependent minors.
There were concerns about how expenses — from traumatic injuries from a car crash that required extensive care for less than a year, for example — might factor into eligibility for Choices for Care for that population.
However, Vermont Legal Aid told the Legislative Committee on Administrative Rules that it is no longer objecting, provided that the state continues to work with them on program implementation.
“When we saw how the state was describing Choices for Care eligibility, it didn’t jibe with our experience and it wasn’t consistent with what we understood from previous state officials,” said Trinka Kerr, chief heath care advocate for Vermont Legal Aid. “We were concerned about what it meant for a very small group of pretty vulnerable people.”
State officials say they received assurances from the Centers for Medicare and Medicaid Services that the rule is consistent with federal law.
But this resolution won’t end the conversation about Vermont Legal Aid’s concerns.
“We’re not simply saying, ‘No, we’re right and you’re wrong.’ We really want to make sure that anything that created the misunderstanding is improved, clarified and resolved,” Hickman said.
State officials plan to file the set of provisions by next week so they can go into effect before emergency health care rules expire July 29.
But there’s still work to be done on determining how the consolidating eligibility requirements might affect Vermonters.
“I’m still worried about that little group,” Kerr said. “We have to figure out what the state can do for them, if anything.”