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A bill that received little attention outside of the Statehouse was signed into law today by Governor Scott. H524 originated in the House Healthcare committee after weeks of testimony and thoughtful discussion. It is a broad marketplace stability bill that seeks to protect Vermont's insurance exchange and to protect Vermonters from the dismantling of the affordable care act.
In the health care world, we are often working to balance two opposing schools of thought. One side looks for an expansion of government, and simplification of the existing system by limiting payers. Conversely, another point of view looks to enhance competition, and subject the health care market to a fully free market system. While the visions from each side may be worth pursuing in the long term, it is important for Vermonters to have a functioning and accessible health care system today. This legislation looks to address the pressing concerns of today, while continuing to consider more systemic reforms to how we provide - and pay for - health care in our state. Although this legislation covers many pieces of health care, the most important to me is the consumer protections, that are in the affordable care act, but were not in state statute. If the affordable care act is repealed or dismantled, now, in Vermont we will have the following protections:
In my short 3 years in the legislator, the house healthcare committee has continued to battle against the threats at the federal level to dismantle the affordable care act. H524 is a giant step forward in protecting Vermonters. Yes, we still have a lot of work to do on cost and access. But I will rest a little bit easier tonight knowing we have these protections.
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Well our goal was to be finished with the 2019 legislative session on May 18th. As we all know sometimes deadlines must be pushed out. Although only the budget and revenue bills must pass prior to adjournment there are still several priority initiatives we are hoping to finalize this week. Below is a recap of the legislative session thus far:
55 bills have been passed by both the House and Senate while 26 of those bills have been enacted into law. Bills enacted into law include (but not limited to):
Bills awaiting the Governor’s action include (but not limited to):
Bills yet to be resolved between House and Senate include (but not limited to):
Fortunately this is year one of the biennium so unresolved bills will carry forth to next year. I’m happy to talk further about any of the bills listed here and those not listed. I can always be reached at lhoughton@leg.state.vt.us or 373-0599. June 1st is the next Essex/Westford community conversation from 8:30am to 10:00am at The Nest Café located on Main St in the Village. The time we spend in Montpelier is productive and important, but so is spending time in the community. I look forward to adjourning this week and seeing everyone around the Village. Please don’t ever hesitate to stop me in the street, at the grocery store or anywhere else – I’m always happy to chat. Thank you for the continued opportunity to serve Essex Junction! Please join us for our next community conversation June 1st from 8:30am to 10:00 am at The Nest located at 17 Main St in the Village. We will provide a wrap up of the session (hopefully!) and answer questions. Come early, come late – stay for 10 minutes, stay for the whole time. Hope to see you there!
As the session winds down the only must pass bill is the budget. The budget always begins in the House, then is sent to the Senate. The Senate passed their budget out of Appropriations Friday with floor action expected this week. Once they pass, the House Appropriations committee will review and either concur with their amendments or recommend that the two bodies meet in a conference committee to hash out the details. Two of the bills we passed last week (there were 6 total) include: S. 40 an act relating to testing and remediation of lead in the drinking water of schools and child care facilities which requires all school and childcare facilities to test for lead in the water. As passed the bill attempts to cover the full costs of any needed remediation and replacement of fixtures with an appropriation of $3.2 million. S.43 an act relating to prohibiting prior authorization requirements for medication-assisted treatment which prohibits a health insurer from requiring prior authorization for a patient receiving MAT and for any counseling and behavioral therapies associated with that treatment. The House Government Operations Committee passed out their version of the bill to tax and regulate marijuana which is quite different from the Senate passed bill. The bill can be found at www.legislature.vermont.gov under House Calendar dated Friday May 3rd. Some of the changes the House made – towns will need to opt in to allow a retail establishment, 30% of tax revenue will be routed to a specific fund for prevention and concentration levels are capped. The bill is now going to House Appropriations and House Ways and Means. No timeline yet on when the bill will make it to the floor. A big thank you to all who helped on GreenUp Day and to all those residents I see picking up trash as they take their walks – without it having to be GreenUp Day. It does take a Village! Please reach out with questions, comments or concerns. Thank you for the continued opportunity to serve Essex Junction. Lori Houghton With the end of the session just a few weeks away, I will focus our attention on three bills working their way through committees to reach the floor for a vote. I appreciate constituent feedback and can be reached at lhoughton@leg.state.vt.us.
S169 an act relating to firearms procedures, otherwise known as the waiting period bill, currently in House Judiciary would require a 24 hour waiting period on hand gun transfers after the completion of the background check. It would not apply to hand gun transfers that do not require a background check. The bill also makes changes to various pieces of the 2018 gun legislation related to large capacity ammunition feeding devices, shooting competitions, reporting on extreme risk protection orders and allows for, does not require, healthcare provider notification options. S23 an act relating to increasing the minimum wage passed out of House General and will now go through the money committees. The bill would raise the minimum wage gradually until it reaches $15 in 2024. Thereafter, the minimum wage would increase each year by the percentage increase in the Consumer Price Index. Unfortunately, no language was added to raise the wages for Medicaid-funded health care workers. Over the past two years we’ve worked on this issue in the health care committee increasing funding for mental health workers, but workers at home health agencies, nursing homes and others have not seen an increase in wages. This is an issue we need to focus on in the near term. S54 an act relating to the regulation of cannabis. Although a vote in the committee has not yet occurred and language is not final, the committee has added language regarding a Substance Misuse Prevention Fund. Thirty percent of the revenues raised by the cannabis excise tax, not to exceed $6 million per fiscal year, would go to the fund for prevention education. No decisions, as of this writing, have been made to roadside testing requirements. Other areas of importance from last week – the House Energy and Technology committee held a public hearing on proposed bills that would ban or limit new fossil-fuel infrastructure (H.51, H.175 and H.214) The hearing was well attended and the committee will continue to work on this issue. The House passed S.86 which will increase the legal age for buying and using cigarettes, electronic cigarettes and other tobacco products from 18 to 21 years of age. Passed originally in the Senate the House concurred with their language except to change the effective date to September 1, 2019. This was the third leg of our strategy to reduce youth tobacco usage. Please reach out with questions and comments! Thank you for the privilege to serve Essex Junction. Lori Houghton Please join us for our next community conversation June 1st from 8:30am to 10:00 am at The Nest located at 17 Main St in the Village. We will provide a wrap up of the session (hopefully!) and answer questions. Come early, come late – stay for 10 minutes, stay for the whole time. Hope to see you there!
A few of the bills we passed last week (there were 6 total) include: H207 an act relating to approving an amendment to the charter of the City of Montpelier regarding non-citizen voting in City elections. This approval, if passed by the Senate, will allow legal non-citizens to vote in city elections. S.49 a bill that regulates PFAS in drinking water and surface waters in Vermont on a vote of 135-1. This bill establishes regulatory monitoring of drinking waters to ensure that Vermonters remain safe and manufacturers are held accountable for their waste. On or before December 1, 2019 all public water systems in Vermont will be required to conduct monitoring for PFAS. S.68 which changes the name of the legal holiday from Columbus Day to Indigenous People’s Day. This week: We will take up on the House floor S.86 which proposes to raise the legal age for buying and using cigarettes, electronic cigarettes and other tobacco products from 18 to 21 years of age. The goal of S.86 is to reduce tobacco use by youth and protect developing brains, uniquely vulnerable to the effects of nicotine and nicotine addiction. The Surgeon General predicts that 10,000 Vermont youth alive today will die prematurely of tobacco-related illnesses if we fail to change course. In the House Health Care Committee we will continue our discussion on a bill to license ambulatory surgical centers in Vermont and hear testimony on electronic medical records. As I’m sure all have heard the Senate passed out a bill to tax and regulate marijuana which is now working its way through the appropriate committees in the House. I welcome feedback on this measure – should it pass? With certain restrictions? With specific prevention or safety measures? Please email me at lhoughton@leg.state.vt.us. Thank you for the continued opportunity to serve Essex Junction. Lori Houghton Please join us for our next community conversation April 13th from 8:30am to 10:00 am at Sweet Alchemy located at 45 Upper Main St. This is a time to talk with your Essex area representatives about issues of importance to you. Come early, come late – stay for 10 minutes, stay for the whole time. Hope to see you there!
Last week the House passed out H107 Paid Family and Medical Leave bill on a vote of 92 – 52. As many may know the United States is one of only two countries that does not offer a paid family medical leave insurance program that is universal. Currently only 15% of Vermonters have access to any kind of family and medical leave insurance and some of those aren’t offered a plan that is substantial enough to take any meaningful time off. This legislation seeks to keep Vermonters here and attract new workers, provides a level playing field for small businesses and protects our most vulnerable Vermonter. In its current form, H107, provides eligible employees up to 12 weeks per year for parental and bonding leave and up to 8 weeks for personal medical and family caregiving leave. Total leave in one year cannot exceed 12 weeks. An eligible employee is one who has earned at least $11,200 in at least 6 months of the last 4 calendar quarters. If someone works multiple jobs, the earnings would be calculated across all employment. The program is paid by employee contributions - employers can cover some or all of the cost. There are many more details I can provide for anyone interested. H107 now moves to the Senate. The Health Care Committee, on which I serve, continues its deep dive into understanding Vermont's ACO system. For those who are not familiar with this system, ACO stands for Accountable Care Organization. In its simplest form, ACO's are organizations of providers, usually centered around a hospital and the surrounding care practices, that agree to be collectively held accountable for the quality of care that patients ("attributed lives") receive. The intention of having ACOs is to give medical providers greater flexibility in providing treatment, and incentivize coordination of care. For example, in this model, primary care physicians are financially rewarded when their patients do not need to use the emergency room. Vermont has a single statewide ACO, called OneCare Vermont. Whereas many ACOs in other states are linked only to Medicare, Vermont's ACO uses the "All Payer Model." This means that all the payers - Medicare, Medicaid, Blue Cross / Blue Shield, MVP - are connected to OneCare. The idea of having an ACO is to gradually switch to a "Per Member Per Month" payment model, where provider networks are given a lump sum of money to keep their patients healthy each month, instead of having to bill for every individual service, which is the current "fee for service" system. The testimony we've received surrounding ACO's has raised a number of questions for our committee to continue to work through, including what oversight the state should have over OneCare Vermont, whether having an ACO will really change the quality of care received, and how the savings from the ACO compares with the administrative cost of the ACO. Thanks for your time in reading the legislative updates. Please don't hesitate to reach out with questions or comments. Thank you for the continued opportunity to serve Essex Junction. Lori Houghton The daily schedule has definitely changed. We spent much of our week on the house floor voting on bills that passed out of committee prior to crossover. In the healthcare committee we had two bills pass over to the Senate: H83 Act relating to female genital cutting (FGC) and H528 The Rural Health Services Task Force.
Regarding H83, In 1996 Congress passed legislation prohibiting female genital cutting (FGC). This past fall, a federal judge in the Eastern District of Michigan dismissed a case against two doctors and others who were charged with violating the statute. The judge found that Congress overstepped its bounds by legislating to prohibit FGC because under our federal system of government, local criminal activity is for the states to regulate, not Congress. The case is on appeal, but the District Court ruling is likely to reduce or eliminate the chances of it being used by federal prosecutors around the country, and signals that the states need to regulate FGC if they want to prohibit the act. This is an important piece of legislation. Regarding H528, rural health care systems are facing challenges all throughout the country. More than 100 rural hospitals have closed in the US since 2010, and here in Vermont at least one critical-access hospital is facing financial crisis. While we are concerned about the future of Vermont’s rural hospitals, we also recognize that the rural health care continuum consists of many more service providers than just hospitals. These service providers are often interwoven into networks of care. So H528 creates a Task Force to bring together representatives from the different components of the rural health care continuum, and would ask the members of the Task Force to think boldly about the future of this system. A bill of importance to many in our community and the broader state is H531 - an act relating to Vermont’s child care and early learning system. The House Human Services committee voted unanimously out of committee and is headed to the house floor this week. The Human Services Committee views this legislation as a first step in addressing the current child care crisis in Vermont. If it becomes law, it will be part of a multi-year strategy to improve and strengthen child care laws and regulations, a priority of both the Legislature and the Administration. H. 531, does the following:
I’m excited to share two upcoming events: Please join the Essex Democrats Open House, Saturday March 30th 6-7:30 at Brownell Library, Kolvoord Room, 6 Lincoln St Essex Junction. Local residents are invited to learn more about the Essex Democrats, consider joining the committee, meet current members, and get up to speed on issues. This event is free and open to the public. Light refreshments will be served. See the facebook event link here for more details: https://www.facebook.com/events/2196573720606128/. Our next community conversation will be April 13th from 8:00am to 9:30am at Sweet Alchemy located at 45 Upper Main St. This is a time to talk with your Essex area representatives about issues of importance to you. I look forward to hearing from residents, so please reach out with comments or questions! Thank you for the continued opportunity to serve Essex Junction! We are now in the middle of our Town Meeting week break. Thank you to all who come out to the Town of Essex meeting on Monday night to vote on the budget – which passed. Thanks also to all who voted yesterday for Selectboard. Patrick Murray and Annie Cooper were elected to the Essex Selectboard. Congratulations to both. Thank you to Irene Wrenner for her many years of service.
The Village of Essex Junction will hold our annual meeting April 3rd at Essex High School. This is the time we vote on the municipal budget. A free community dinner begins at 6pm with the meeting beginning at 7pm. Essex Westford School District will hold their annual meeting Monday April 8th at 7pm at the Essex High School Auditorium. Voting on the budget occurs April 9th from 7am to 7pm. Back to the Statehouse. The House is currently working on the FY2020 budget. The House is on target to advance this budget proposal shortly after our break. The budget will be balanced – to meet the needs of Vermonters while keeping ongoing spending in check. While building the budget, the House Appropriations Committee goes deep into the numbers, hearing testimony from all state-related entities. They look at old and new initiatives to ensure they are accountable and provide value for the residents of Vermont. They question proposed reductions, as well increases, position changes, perceived program delivery hurdles, use of "one-time" money, and "vacancy savings." They seek the input from all policy committees and testimony from advocates. I'll be reporting more on the budget in coming weeks. Two bills relating to tobacco and E-Cigarettes passed their respective chambers. In December 2018, the Surgeon General declared an epidemic regarding e-cigarette use among teens. This action was prompted by new data showing a 78-percent increase in e-cigarette use among high school students in just one year's time (2017-2018). In that same timeframe, middle school use increased by 48 percent. Teens who use e-cigarettes are four times more likely to become regular tobacco users. The Vermont House voted to pass H47, which places an excise tax on the liquids and delivery devices of e-cigarettes to discourage use among youth who are the most price-sensitive consumers. Just as we tax other tobacco products, 92 percent of the wholesale value of the e-cigarettes will be collected at the licensed distributor level and used for prevention purposes. The Senate passed S86 which increases the legal age for buying and using cigarettes, e-cigarettes and other tobacco products from 18 to 21 years of age. Both of these bills have crossed over to the other chamber for testimony and action. Our next community conversation will be March 17th at 2:00pm at The Nest Café on Main St in the Village. This is a time to talk with your Essex area representatives about issues of importance to you. I look forward to hearing from residents, so please reach out with comments or questions anytime through the contact section on the website or lhoughton@leg.state.VT.us. Thank you for the continued opportunity to serve Essex Junction. Lori Houghton This past Friday marked the departure of the first class of Legislative Pages. Through the session we have three groups of pages – each group staying 6 weeks. Pages are vital to our work. One of their most important roles is to deliver messages from our constituents in a timely and confidential manner.
Their departure also signals that we are about 1/3 of the way through the 2019 session. Crossover – the date policy bills must be voted out of their respective chamber to cross over to the other chamber – is March 15th with the budget following a week later on March 22nd. The Health Care committee has been busy during the last two weeks taking testimony on several issues relating to the stability of the health insurance marketplace. We talk a lot about the need for a “stable risk pool,” which basically means that the more people who purchase health insurance in the same market, the lower and more stable each member’s rates will be. The President has removed the national financial penalty for not purchasing health insurance, and we are discussing whether if and how we should enforce the health insurance mandate at the state level. We have continued to discuss health insurance options for small businesses, as well as, mandating coverage for people with pre-existing conditions. This coverage is required by the Affordable Care Act but is not a state statute. February 14th was suicide awareness day at the statehouse. Vermont suicide deaths are above the national average and are also increasing at a faster rate than the national average. One of the issues is that many doctors in Vermont do not have the training to provide adequate support for someone with suicidality. Regarding guns and suicide: access to guns does not increase the number of suicide attempts, but it does increase the deadliness of those attempts and therefore the number of deaths by suicide. The General, Housing and Military Affairs committee voted out the paid family and medical leave bill. In its current form the bill proposes up to 12 weeks of paid family and medical leave financed through an insurance premium, shared equally by employers and employees. The committee made changes to expand the definition of family, expand the foster care age to 18 and to clarify language throughout. Further iterations on the financial modeling and tax income ramifications will be developed in the next two committees - Ways and Means and Appropriations. The administration has also proposed a paid family leave plan. We had a lively group at our community conversation Sunday. Our next conversation is March 17th from 2:00 to 3:30pm at the Nest Café on Main St in the Village. This is a time to talk with your Essex area representatives about issues of importance to you. Hope to see you on the 17th. Feel free to reach out at anytime with questions or comments! Activity in committees and on the house floor picked up this week. House bills that passed out included:
Wednesday was Mental Health Advocacy Day and in the health care committee we had various organizations provide testimony on what is happening in our communities. Mental health will be a continued focus of our committee this year with an emphasis on community based programs. On Friday we watched the movie "Faces of ACEs". I came away with a new understanding of how the trauma we experience as a youngster effects our adult life. We must integrate this learning in all health care discussions. In the health care committee we ended the week hearing testimony from the Individual Mandate Working Group. In 2018 Act 182 established an individual mandate for Vermont residents to maintain minimum essential health insurance coverage beginning January 1, 2020. The act created a working group to develop recommendations regarding the administration and enforcement of an individual mandate. We will continue hearing from the working group on their recommendations to determine how we move forward to ensure the stability of the Vermont health care market. Public Hearing has been set for Wednesday Feb 6th on H57 an act relating to preserving the right to abortion. In Vermont we follow Roe vs Wade but that law is not codified in state law. H57 will codify Roe Vs Wade into state law. This hearing will take place at the Statehouse from 4:30 pm to 6:30 pm. If you wish to provide testimony sign ups will begin at 4:00pm. We are expecting a large crowd so please arrive early. As always, please reach out with questions, comments or concerns. Lori |
