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Burlington Free Press: Welch urges 'full speed ahead' for health care reform

January 18, 2017
In The News

MONTPELIER - Rep. Peter Welch, D-Vt., mixed dire predictions with a rallying cry Wednesday as he told Vermont lawmakers to "continue full speed ahead" on health care reform despite the pending repeal of the Affordable Care Act, which affects insurance rates, Medicaid funding, health coverage for young adults and many other aspects of the state's health care system.

"It feels like Washington has lost its way," said Welch, D-Vt., who served as a leader in the Vermont Senate before his election to Congress. "And I say this quite sincerely: Montpelier and other state capitals have to lead us back to the light."

Vermont has begun several health care reform initiatives, including most recently a deal with the federal government known as the "All-Payer" waiver that would change the way health care providers are paid. Welch predicted that the federal government is likely to uphold the deal, but that overall funding related to health care may be threatened, impeding Vermont's ability to meet the goals of the waiver.

Welch predicted a wide-ranging fallout if Congress and President-elect Donald Trump repeal the Affordable Care Act, as they have promised, and if there is no replacement for the law. Congress recently passed a resolution that clears the way for repeal. Trump has said he will share a plan to replace the law after the Senate confirms his nominee for Health and Human Services secretary, Tom Price.

At a confirmation hearing in Washington on Wednesday morning, Price tried to reassure lawmakers who were worried about Americans losing health coverage after the repeal of the Affordable Care Act.

“We believe that it’s absolutely imperative that individuals that have health coverage be able to keep health coverage and move, hopefully, to greater choices and opportunities for them to gain the kind of coverage that they want for themselves and for their families," Price said, according to a New York Times report.

Welch said he was seeing a "step-by-step unraveling" of the health care law, and that incremental changes could undermine the integrity of the whole system. Repealing the so-called Cadillac tax on high-benefit health care plans, for example, might seem popular but would lessen funding for the Medicaid expansion that allows more Vermonters to have health coverage.

He hoped to work with Republican colleagues in Congress to identify the real consequences of a repeal.

"Reality has a harsh way of imposing itself on your fictional account of what's going to happen," Welch said.

Vermont House Speaker Mitzi Johnson, a Democrat, told Welch that lawmakers in Vermont are closely watching the federal government. She said lawmakers are organizing a "response team," led by Rep. Sarah Copeland-Hanzas, to collect and share information about federal changes that will affect Vermont.

"We obviously can't freeze our work and just wait for something to happen," Johnson said, "so we will continue moving forward to the best of our knowledge and ability."

Rep. Anne Donahue, R-Northfield, said it would be important for Vermont to stay tuned in to federal changes, especially regarding funding for health care programs. Federal funds account for about $2 billion of funding in Vermont this year, according to the Legislature's Joint Fiscal Office, about half of which is related to Medicaid. Of all states, Vermont is the fourth most-reliant on federal grants per capita.