Universal healthcare is the only way out of Vermont's policy trap

COMMENTARY

"I'm a single mom who just got kicked off of Medicaid. There is no way I can afford a plan on the exchange."

"Having Medicaid took the load off the many challenges living with chronic illness comes with. I lost Medicaid, and the financial burden is now back on me."

"Our one-year-old was in the first round of people kicked off Medic-aid. I want to live in a society where babies are guaranteed health care."

"I'm due to lose my Medicaid while I have cancer."

"I have no control over Type 1 diabetes. It's an autoimmune disorder, and it feels like I'm being punished with a bill just to live."

Thirty thousand Vermont residents have been cut from Medicaid since April 2023, following a bipartisan federal decision to end pandemic protections for the program. The testimonies above, shared with the Healthcare is a Human Right Campaign, reflect the consequences of what Bishop William Barber II of the Poor People's Campaign refers to as "policy murder."

Our healthcare system is inflicting violence on millions of people nationwide and thousands in Vermont who are living with serious medical issues while facing the added stress of crushing medical bills. At the same time, the rising cost of health insurance is driving up school and town budgets, putting public education at risk.

On Jan. 12, the same day as a Statehouse rally demanding a halt to the Medicaid cutoffs, Rep. Lori Houghton and Sen. Ruth Hardy introduced legislation to expand Medicaid access and boost reimbursement rates for primary care and other types of care.

The Medicaid Expansion Act of 2024, H.721, opened a necessary dialogue on equitable access to healthcare. It promised, in the words of the sponsors, to "bring the focus back to Vermonters by expanding access to comprehensive health care for thousands of people who are struggling to afford a visit to their doctor." Yet by the end of February, most of the bill had been watered down to a study without a provision to analyze the costs and benefits of healthcare for all.

Why did we have to wait until thousands of people were stripped of their access to healthcare for legislators to even begin talking about expanding access to Medicaid? By turning most of H.721 into a study without a clear implementation timeline, policymakers are perpetuating the suffering and insecurity people are experiencing right now - which will only get worse when the enhanced federal subsidies for Vermont Health Connect premiums expire in 2026.

In 2011, Vermont policy-makers passed Act 48, a groundbreaking law that set a path to establish a publicly-financed universal healthcare system. A study commissioned by Act 48 found that universal healthcare would raise net incomes for 9 out of 10 Vermont families while securing comprehensive coverage for all residents. Yet a coordinated campaign of pushback from big business and the healthcare industry was enough to scare political leaders into reneging on their responsibility to implement the law that the legislature had passed.

This is the crux of any attempt at substantial healthcare reform: It requires leaders to summon the political will to confront entrenched ideas and interests, and to stay in the fight through to victory.

The Medicaid Expansion Act of 2024 oriented the policy discussion in the right direction, and contains an important provision to support low-income elders and people with disabilities. However, small reforms, because of the fragmented nature of our healthcare system, often just add to the complexity and irrationality of the system as a whole and pit sections of our communities against one another.

Universal healthcare is the only way out of this policy trap. We need an updated study of the benefits and costs of implementing a universal, publicly-financed system, as laid out in Act 48.

This month, the Healthcare is a Human Right Campaign kicked off a Spring Tour of community meetings on the healthcare crisis. Dozens of people came to the first event in Brattleboro, sharing their frustration with navigating a complex system to get the care they need, and the challenges this system creates for both patients and healthcare workers. Simply put, people in our communities are going untreated and suffering adverse health consequences, even financial ruin, for no fault of their own.

Policy violence is real. And it's going to take an organized social movement, with the support of committed elected officials, to lead the way to realizing healthcare as a human right and a public good. If you or your family have been cut off from Medicaid or impacted by high healthcare costs, barriers to getting the care you need, or medical debt, join us at an upcoming Spring Tour event to share your story. For more, check out workerscenter. org/2024springtour.

Karen Saunders serves as vice president of the Vermont Workers' Center. The opinions expressed by columnists do not necessarily reflect the views of Vermont News & Media.