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Lawmaker revives proposal to pool public funds into hospital 'security' trust and statewide global budgets
Summary
Representative Francis Chopper McPhomb reintroduced a proposal (discussed as bill 267) to create a hospital security trust fund that would pool public hospital dollars into a statewide global budget to cover hospital care and reduce individual patient bills.
Representative Francis Chopper McPhomb presented a proposal (referred to in committee discussion as bill 267) to establish a "hospital security" plan and trust fund that would collect public hospital‑care dollars into a statewide budget covering hospital services.
"There's a hospital security trust fund to finance this bill and into that trust fund, it goes all of the Medicaid, Medicare money, all of the public money and we have to get waivers to do that," Representative McPhomb told the House Committee on Health Care. Under the idea described by McPhomb, the trust fund would finance a negotiated statewide global budget for hospital health care; individual hospitals would then negotiate an allocation from that statewide budget to cover operating needs.
McPhomb said a special hospital security plan committee would be established to recommend funding sources to fill the trust fund, and the draft bill suggests options such as a payroll tax or an income tax. "There's a hospital security plan special committee that's established to determine, make recommendations on where the money is going to come from to fund this," he said.
Sponsor and committee comments stressed the proposal aims to reduce patient exposure to large hospital bills. "And you go to the hospital, we receive the services that, we need and we go home and we don't worry about a hospital bill," McPhomb said. He framed the measure as building on interest in global budgets by hospitals and as a way to stabilize costs and access.
Committee members asked whether the plan would apply to hospital systems with facilities outside Vermont and whether the trust would cover care provided to out‑of‑state residents who come to Vermont hospitals. McPhomb responded that networks with hospitals outside Vermont would be exempt from the plan, but if a Vermont hospital treated an out‑of‑state patient the trust would pay for that care; conversely, visitors to Vermont would be responsible for their care, he said.
McPhomb said the bill builds on earlier iterations he introduced in prior years and cited models in Rochester, N.Y., and examples in Canada. He acknowledged the proposal would prompt many questions and stakeholder interest and said the committee would likely hear more testimony if the bill is taken up.
No formal committee vote was recorded during the discussion; sponsor said he would pursue stakeholder briefings and the committee indicated it would invite interested parties to testify.
