Gov. Douglas’ statement on why he refused to sign S.88, the health care reform bill

JAMES H. DOUGLAS Governor yi/. State of Vermont OFFICE OF THE GOVERNOR May 27, 20l0 The Honorable David A. Gibson Secretary of the Senate State House I I5 State Street, Drawer 33 Montpelier, VT 05633 Dear Mr. Gibson: Pursuant to Chapter II, Section I I ofthe Vermont Constitution, I will allow S. 88, An Act Relating to Health Care Financing and Universal Access to Health Care in Vermont, to become law without my signature for the reasons stated herein. S. 88 includes a number of provisions that I strongly support and a number of provisions about which I have significant concerns. On the one hand, it provides critically important codification of our Blueprint for Health -- Vermont's signature, forward-thinking effort to improve quality and reduce growth in health care costs. But at the same time, physicians, non-profits and other organizations across Vermont have expressed significant concern about the chilling effect certain provisions could have on the ability of low-income Vermonters to receive free samples of vital prescription drugs. And family-owned restaurants in Vermont have voiced concem about S. 88's accelerated implementation of menu labeling requirements that were included in recently enacted federal health care reform. Vermont has been at the forefront of state-led health care reform efforts and worked closely with our Congressional delegation on the recently enacted Patient Protection and Affordable Care Act. After tive solid years of state-led reform and with President Obama's sweeping health care law barely in hand, S. 88's "design options" study mandates that Vermont now consider striking out on its own, in a totally different direction. Moreover, the study is a wasteful expense of time and scarce resources, as Vermont would be prevented by the federal health care reform law from implementing any of the new "designs" until 2017 at the earliest. I thank the Legislature, however, for the careful, positive work they put into many provisions of S. 88. The revisions to the Blueprint are vitally important, outweighing the other objectionable portions ofthe bill. Indeed, the bill represents the culmination of years of work positioning Vermont to lead the nation in a comprehensive effort that has been recognized for its groundbreaking innovation in a multi-payer approach to payment and delivery system reform. The need to enact the Blueprint revisions rests on two critical developments in the evolution of the program that require legislative authority. First, the Blueprint's integrated medical home and community health team payment reform model grew out of language 109 STATE STREET THE PAVILION MONTPELIER, VT 05609-0101 FAX: 802.828.3339 TDD: 8o2.828.3345 -rlIIT MIIvtIglu_-r..il**.1?r I I - - IMII(fix . - II-5 _--.-IiiI-V-.: rtH-gil.-I FVIHI 1-II-11