Health care activists won a victory on Tuesday when a House/Senate conference committee agreed to strip an amendment that would block undocumented residents from receiving coverage under the proposed Green Mountain Care health insurance program.
The Senate had inserted the language into H.202, the universal health care reform bill, but House conferees resisted it. Late Monday night, the committee members decided to strike the amendment language and replace it with a study of coverage and services for undocumented residents.
Eliminating the Brock-Sears amendment - named for Sen. Randy Brock, R-Grand Isle/Franklin, and Sen. Richard Sears, D-Bennington - was the last significant stumbling block for this historic bill. It now goes to the full House and Senate for final approval.
Rep. Mark Larson, D-Burlington, chair of the House Health Care Committee, proposed to eliminate the clause because he said it raised legal, financial, and larger moral issues.
About 1,500 to 2,000 undocumented dairy workers from Mexico are employed by Vermont farmers and they are credited with helping to keep the dairy industry solvent at a time when few Vermonters are willing to work on farms.
Meghan Sheehan, one of the nearly 40 activists from the Vermont Workers Center attending Monday's conference committee hearings, said she was pleased that the language had been changed.
“This is a divisive issue that is used as a wedge often,” Sheehan said. “Our campaign is clear: health care is a human right regardless of where a person is from. We can't exclude the most marginal people in our community.”
Peg Franzen, president of the Workers Center, said the amendment violated a key principle of the campaign. “This had to happen; we had to be true to the mission,” Franzen said.
The new provision includes four findings, or statements about current federal laws that prohibit the use of Medicaid funding for undocumented residents.
It also calls for a report to be issued in January 2013 that would be presented to the Legislature.
The study must provide information about the potential costs of services provided to undocumented immigrants by health care professionals; increases in the cost of care delayed due to the lack of coverage for primary care; and the potential costs of providing coverage through Green Mountain Care, “including any state funds necessary to fund the services.”
The new language also requires the Secretary of Administration to work with the Vermont congressional delegation to provide a mechanism for legal status for undocumented farm workers and to clarify impacts of covering or not covering them through Green Mountain Care.
The conference committee also worked on a number of smaller issues, including when the Green Mountain Care board would form (the House proposed an October 2011 startup date, the Senate wanted the board members, with the exception of the chair to be hired in January of 2012) and a change in the number of insurance companies on the Medicaid advisory board. (The Senate proposed three; the House didn't include any – they settled on one insurance representative to be appointed by the commissioner of the Department of Vermont Health Access.)
They also discussed a co-pay provision for primary and chronic care that several members of the committee objected to. “We don't want cost-sharing to be a barrier to primary care,” Larson said.
Language about the economic viability of the plan was it issue for a while as well. Sen. Kevin Mullin, R-Rutland, who proposed a series of fiscal conditions that must be met before Green Mountain Care is implemented, said the requirements are necessary.
“This is a check point against ourselves,” Mullin said. “It puts pressure on future legislatures to make sure it's financed properly.”