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Health care advocate flags Bridges to Health, adult dental cap and federal funding draws in budget hearing
Summary
Mike Fisher, Vermont health care advocate, asked for stable base funding for Bridges to Health, recommended steps to expand adult Medicaid dental coverage, urged maximizing federal DSH drawdowns, and highlighted investments in community care programs such as SASH and birthing-center reimbursements.
Mike Fisher, Vermont health care advocate, told the committee on Feb. 19 that his office has no funding request this year but pressed for several budget actions and program investments across the health-care system.
Fisher asked the committee to provide stable base funding for Bridges to Health, an organization that assists hard-to-serve Vermonters with insurance access and community health worker services. He said Bridges is funded through September and needs an additional $675,000 to cover the year; he also urged converting Bridges to recurring base funding and cited a $900,000 baseline figure as a longer-term funding level.
On adult Medicaid dental coverage, Fisher said the state previously raised provider reimbursement (to roughly 75 percent of Delta Dental rates) and increased the annual adult dental cap from $1,000 to $1,500. He said the Department of Vermont Health Access (DVHA, referenced in testimony as “Diva”) reported that eliminating the adult dental cap would cost between $1,830,000 and $5,505,000. Using DVHA’s methodology, Fisher said raising the cap from $1,500 to $2,000 would cost an estimated $646,000 gross annually (subject to Medicaid match), and he urged the committee to take a step to increase the cap while staff refine exact cost estimates.
Fisher urged the committee to maximize federal Disproportionate Share Hospital (DSH) funding, saying Vermont currently draws $22,700,000 and that fully maximizing the draw would require an additional $2,640,000 in general-fund support this year to unlock approximately $6,464,000 gross in federal funds (figures provided in testimony by committee staff).
He also briefly flagged other priorities: support for primary care investments discussed earlier in the hearing; potential increases to Medicaid labor-and-delivery reimbursement rates (noting discussion with hospitals and birthing centers); and support for community-based care coordination programs such as SASH, noting the governor recommended $5,000,000 for SASH and that advocates see room for expansion.
Fisher said he would likely return next year with a modest staffing request for his office but that this year he intends to push for programmatic investments that draw available federal funds and shore up community services.
