This ruling came as no surprise to local community pharmacy owners who have been dealing with low Medicaid reimbursements for years and have been losing money by providing services to Medicaid patients.
Carmen Cintron, owner of the South Orange Pharmacy in Orlando said, “Medicaid has been underpaying for prescription drugs for as long as I have been in business. I try to make sure that my Medicaid patients pay the same amount out of pocket for their drugs as privately insured patients, and often that means I take a loss.”
Medication costs are always on the rise, and local pharmacy owners have seen the greatest increases in the cost of generic drugs. Generics used to be a way that low income folks could afford prescription drugs, but now local pharmacies are even losing money on generic medications.
“Medicaid takes 3-6 months to update their reimbursement rates, while prescription costs rise on a weekly basis. A drug that is profitable for me to dispense one week may lose me money the next week,” said Al Sheikh, owner of Good Homes Pharmacy in Ocoee. “I have a patient whose medication costs me $305 a month, but their Medicaid coverage only reimburses $281. Every time they fill that prescription I lose about $25. I’ve tried passing that cost on to the patient, but they just can’t afford it.”
While business owners and community members across Florida are ready for the state to accept federal dollars to expand Medicaid it is clear that in addition to adding more folks to the coverage plan the state must address low reimbursements that are causing children, families, and small businesses to suffer.
FOR IMMEDIATE RELEASE
Main Street Alliance of Vermont Disappointed at the Slow Down of Universal Healthcare.
Main Street Alliance of Vermont was disappointed to hear that the Governor will not recommend a financing plan for Green Mountain Care to the legislature this year. We are disappointed about the delay and disappointed that the opportunity for stakeholder involvement wasn’t more ubiquitous sooner. We continue to want to move forward to find a plan for universal healthcare that could work and regret that the opportunity to participate in finding a timely solution to the financing challenge as it was presented on Wednesday has been withheld.
We agree and understand that the economy is struggling and we believe that universal healthcare decoupled from employment is an essential ingredient to the success of Vermont’s economy and to supporting small businesses and their employees. We know that in the long run, a truly universal healthcare system, done right, will save Vermont money.
Our current healthcare system continues to be unsustainable and unaffordable for small businesses and for Vermont. Private insurance companies continue to earn large profits while Vermonters struggle to pay for healthcare. Many of Vermont’s small businesses are still unable to afford the high cost of providing health insurance to their employees, and many therefore don’t have access the care they need. The problems we set out to solve remain.
We are closer than we’ve ever been before thanks to all the work that has been done in Vermont to date. The small business owners with whom we work want the opportunity to work with the legislature and the administration to help find solutions to the challenges that the Governor identified and to keep Vermont moving forward this year in every practical and possible way toward the goal of universal healthcare in our state.
The Main Street Alliance is committed to elevating the voices of small business owners to advance public policies that are good for small businesses, our employees, and the communities we serve.
Founding Board Members: Wayne Nelson, L.N. Consulting in Winooski, Melinda Moulton, CEO of Main Street Landing in Burlington, Trudy Trombley, The Boutique at Stowe Mercantile and Truly Trudy’s Cosmetics in Stowe, and Eliza Cain, Red Hen Bakery in Middlesex
On Monday December 15th, Main Street Alliance of Vermont held a press conference and reception to announce their 2015 legislative platform and to release a report of survey findings from a statewide small business survey conducted this past summer and fall.
Dozens of Main Street Alliance coalition members and several legislators were present at the event. Speakers included former Governor Madeline Kunin; Trudy Trombley, MSA member and owner of Truly Trudy's Cosmetics in Stowe and The Boutique at Stowe Mercantile; Stephanie Hainley, MSA member and COO of White and Burke Real Estate Investment Advisors; Representative Jill Krowsinki and Senator Philip Baruth, lead sponsors of this year's Earned Leave bill; Peter Sterling, Director of Vermont Leads, and Andrew Savage, Chief Strategy Office at All Earth Renewables.
Trombley and Hainley reported key findings from the survey, highlighting that out of all businesses surveyed, 49% support establishing a minimum standard of earned leave and just under 60% support moving forward with a universal, publicly financed healthcare system in Vermont.
See the links below for media coverage from the event:
VT Digger (Article) My Champlain Valley (Article & Video) Times Argus (Article) WPTZ (Article & Video)
Vermont has long been a leader in providing quality health care coverage, and now we have an opportunity as a state to demonstrate how to deliver an affordable and comprehensive universal healthcare system. This system could potentially save Vermonters half a billion dollars a year in overall healthcare costs, which is great news for small businesses.
Currently, it’s estimated that Vermonters spend about $2.7 billion annually on health care premiums and out of pocket costs, and although it seems like a big price tag, the $2-$2.2 billion anticipated cost for Green Mountain Care will be an overall decrease. In addition, taking employers out of the health insurance provision system means we'll no longer need to administer health insurance, reducing our overhead. The implementation of universal healthcare presents us with a unique opportunity to benefit the entire state.
In order to achieve these benefits for small businesses and our employees, however, it’s critical that we find the right balance in the financing plan - one that won’t hurt small businesses like ours or hard working Vermonters.
According to the December 5th VT Digger article that reported a leak from the Governor’s Advisory Council, an 8% payroll tax could be a part of the financing package for Green Mountain Care. While 8% sounds like a reasonable starting point for the conversation about payroll tax contributions, we’re eager to learn more about the details. Specifically, how will the payroll tax be phased in for small businesses that aren’t currently offering a healthcare benefit to their employees? And, given that currently the average employee premium contribution covers about 80% of the cost, we would have serious concerns about any plan that shifted that balance too quickly, hurting working Vermonters. Any eventual cost shift needs to allow time for the benefits of universal healthcare and the cost savings we will see from improved health outcomes to flow to everyone.
These will be important details to clarify and to work on with the legislature once the administration’s proposal is released and no matter what the standard payroll tax rate ends up being.
Just as important as the balance of the financing plan is the coverage it provides. As founding members of Main Street Alliance, we support a plan that restores Vermonters to at least the coverage that was available under our Catamount Health Plan and Dr. Dynasaur and that includes dental and vision. We should not roll back the progress that Vermont has already made on this point and we support those who are calling for a higher Actuarial Value -– the better the policy, the better it is for Vermont.
As small business owners in Vermont, we're excited about the opportunity to stay engaged in this process. We are looking forward to the release of the Administration’s full plan later this month and to working with the legislature next year. We know that in the long run and done right, universal healthcare will save everybody money. When everybody saves money, they have more to circulate back into the local economy, and that's good for Vermont Main Street businesses and our employees.
This article was submitted by four of Main Street Alliance of Vermont's founding members: Wayne Nelson, L.N. Consulting in Winooski, Melinda Moulton, CEO of Main Street Landing in Burlington, Trudy Trombley, The Boutique at Stowe Mercantile and Truly Trudy’s Cosmetics in Stowe, and Eliza Cain, Red Hen Bakery in Middlesex
The Main Street Alliance is committed to elevating the voices of small business owners to advance public policies that are good for small businesses, our employees, and the communities we serve.
What Do Vermonters Think About Green Mountain Care?
Vermont’s unexpected election results have led to a lot of speculation among Vermonters and in the media. Many have asked whether this election should be interpreted as a reflection on Green Mountain Care, Vermont’s proposed universal, publicly financed, single payer health care system. My response to this is: Yes. The election results suggest we should move forward.
It’s no secret that the implementation of Vermont Health Connect, our execution of the federal Affordable Care Act (ACA) – sometimes called Obamacare, has been problematic and troubling to many people. The election is very likely, at least in part, a reflection of people’s dissatisfaction with the rollout of Vermont Health Connect. But that dissatisfaction does not include Act 48, the legislation that established our intent to enact Green Mountain Care, the first universal, publicly financed healthcare system in the country. On the contrary - the legislature, the administration, and the advocacy community should feel encouraged, if not compelled to redouble efforts to move forward with Act 48 and Green Mountain Care.
Moving forward with Green Mountain Care is our way and the best way to move beyond Vermont Health Connect and the ACA and actually improve healthcare. Specifically, implementing Green Mountain Care: a true universal, publicly financed healthcare system, promises to decouple healthcare from employment, decrease administrative overhead, lower cost to consumers, improve access to healthcare, and improve health outcomes.
Main Street Alliance has spent the past four months traveling around the state and speaking one-on-one with hundreds of small, main street business owners about some of the issues facing Vermont, including healthcare. In these conversations, we’ve learned that there is a lot of confusion and uncertainty about Vermont’s efforts to reform healthcare in the context of the existing and federally mandated Affordable Care Act.
There’s been a lot of healthcare reform lately – so much that keeping it all straight is a legitimate challenge. But one thing is clear to us based on hundreds of conversations: proponents of universal, publicly financed healthcare need to effectively communicate with Vermonters about the difference between the ACA and Green Mountain Care. Most importantly, we need to make it clear that Green Mountain Care will move us out of Vermont Health Connect and the ACA and into a system that will be much more akin to providing Catamount or Dr. Dynasaur for all Vermonters, that it will take private insurers out of the equation, decouple healthcare from employment, and be paid for through a progressive tax that will replace premiums. Green Mountain Care is a Vermont healthcare system that will include and cover all Vermonters just because they’re Vermonters.
In our conversations, we’ve found that the majority of small business owners (most of whom are not currently providing healthcare to their employees), are supportive of the idea of a universal, publicly financed healthcare system. Of course, they’re eager to see the financing plan and the benefits package, as we all are, to be able to assess the administration’s specific proposal. But the support for the concept – the support to apply for a waiver to the ACA and to move forward with a universal, VERMONT plan that takes private insurers out of the system - is resounding. As one small business owner from Windham county said: “I’d love to see healthcare come from the state; small businesses can’t afford to offer it.”
Please visit our website to see the list of businesses that have formed a working coalition to support moving forward with universal, publicly financed healthcare in a responsible way. A full report on Main Street Alliance of Vermont’s 2014 Small Business Policy Project will be released in December.
This article was written by Lindsay DesLauriers, State Director at Main Street Alliance of Vermont and resident of Huntington. It was originally published in VT Digger and subsequently in the Barre Montpelier Times Argus.
Main Street Alliance of Vermont is happy to announce that we have joined with five other organizations to form the new Green Mountain Care Coalition. Each organization in the coalition independently supports Vermont in moving forward with Act 48, the legislation that established Vermont’s intent to enact Green Mountain Care, the first universal, publicly financed healthcare system in the country. Together, we support a healthcare system that is decoupled from employment, that will lower cost to consumers, improve access to healthcare and improve health outcomes for Vermonters.
Is Vermont delivering on the promise of quality, affordable health care for women?
Families depend on both men and women to make ends meet. Women across Vermont are leading households and supporting families. It’s critical to make sure that all women are getting the health care they need to lead healthy, prosperous lives. As the World Bank says: Gender equality is smart economics.
The 2014 Women’s Health Report Card for Vermont underscores that we have a lot to be proud of — Vermont continues to lead the nation in women’s health. In the report card, Vermont was ranked No. 3 and earned a final grade of A. This report ranked all 50 states on 30 measures of women’s health, including coverage, access to care and health outcomes.
I was pleased to see this glowing grade as more evidence that Vermont is on the right track and is a leader in health care. However, I also took this opportunity to educate myself on Green Mountain Care — the next step in Vermont’s health care leadership. I’ll admit that I knew very little about the universal, publicly funded health care system outlined in Act 48. This is something to which the state of Vermont has already committed, and now I can comfortably say that I support this path forward and urge others to get educated.
So what is Vermont doing right? The positive strides of the Affordable Care Act expanded health coverage to more women through the new health insurance marketplaces and through Medicaid, improved coverage of preventive care, created stronger oversight of insurance rates, and increased quality improvement initiatives.
But can Vermont be doing better? Yes. There is room for improvement to ensure that all women in Vermont have access to the health care they need to lead healthy and prosperous lives — especially women of color. Our great report card cannot erase the truth that women of color in Vermont are still less likely to have health coverage, access to health care, and have poorer health.
Looking at the measures of women’s health by race, 6.1 percent of white women in Vermont report being uninsured. That percentage rises to 8.4 percent for black women and then jumps to 17.3 percent of Latinas. Additionally, 11.7 percent of elderly women earning less than 138 percent of the federal poverty level are uninsured along with 9 percent of those between 138 percent and 400 percent of the poverty level. These upsetting disparities will be erased if Vermont moves to Green Mountain Care in 2017. All Vermonters will have health insurance, just by virtue of being a Vermonter.
Vermont has a special opportunity to achieve the equality that is missing here and throughout the nation. There are many leaders working to balance the financing of this system; to translate the dollars we are already spending on health care into an equitable, universal system. This is enormously complicated, and the devil will truly be in the details. While not increasing the burden on individual Vermonters and Vermont businesses, we need all of our state leaders to side with women and communities of color to make their health a priority — to give our mothers, sisters and daughters full and fair opportunities that begin with quality, affordable health care.
Please join me in supporting our legislators’ commitment to work with the administration to finance Green Mountain Care. And let’s make an example of our state with a true system that is fairly financed, does not harm economic growth and achieves the equality we all deserve.
Stephanie Hainley is Chief Operating Officer at White and Burke Real Estate Investment Advisors in Burlington. She a founding board member at Main Street Alliance of Vermont and is past president of Burlington Business & Professional Women. This op-ed was originally published at the Barre Montpelier Times Argus and subsequently in the Burlington Free Press.
Women and working family issues addressed in new State of Main Street report
Portland, OR - This morning, Main Street Alliance of Oregon leaders, Deborah Field, co-owner of Paperjam Press, and Sara Howe and Christy Cushing, co-owners of Howe Innovative Design, met with Congresswoman Suzanne Bonamici to release the new survey report, State of Main Street. This report challenges conventional perceptions of small business owners’ thoughts on key policy issues. It details responding business owners’ views on key issues facing Oregon and the nation.Sara Howe, Christy Cushing, Deborah Field, Congresswoman Suzanne Bonamici, Stephen Michael, and Sean Place. Photo credit: Kristin Rasmussen, Dist. Rep for Suzanne Bonamici (left to right)
Oregon small business owners are supportive of giving Oregon working families a fair shot—real opportunities to succeed and prosper with policies like basic standards for paid sick days as well as safe, secure, and effective retirement savings vehicles for small business owners and their employees. Women small business owners and business owners of color are particularly supportive of these policies. There is a clear call from the small business community that it’s time to rethink the “business as usual” agendas promoted by Big Business and special interest groups. We need to move towards understanding the whole picture of how our businesses interact with the communities we serve.
“Small businesses are a critical part of Oregon’s economy, especially in rural areas. Policies that support small businesses help create economic security and stability for working Oregonians. These policies include access to capital for those who want to start a new business, quality education, stable housing, and affordable health care,” Congresswoman Suzanne Bonamici said. “When families earn a living wage, can take paid leave, and do not struggle to pay for child care, they are more likely to succeed and thrive. The Main Street Alliance report recognizes that these policies are good for small businesses because they lead to healthier families, a stronger local work force, increased consumer spending, and ultimately a stronger local economy.”
“As we continue to recover from this recession, I am committed to helping small businesses remain competitive in today’s market,” said Congressman Earl Blumenauer. “This report, issued by The Main Street Alliance of Oregon, clearly outlines some of the challenges that remain. While I’m concerned the benefits of our economic recovery aren’t being broadly felt, it’s encouraging to know Oregon’s small businesses feel as strongly as I do about the importance of affordable, quality healthcare, reforming our broken immigration system, and ensuring fair and equitable access to credit.”Sara Howe addresses Congresswoman Bonamici on issues impacting her small web, social media and marketing firm.
The Main Street Alliance of Oregon hopes lawmakers, the media and other decision makers will look closely at the results of this survey in planning public policy. We encourage them to listen and respond to the true voices of Main Street.
Main Street Alliance, a national network of state and locally based small business coalitions, announced this week that they are affiliating a state project in Vermont under the leadership of Lindsay DesLauriers.
“We are thrilled to begin working with businesses in Vermont where so many exciting things are on the horizon,” said Main Street Alliance’s national Director, Amanda Ballantyne. “We worked with businesses in support of the Affordable Care Act and we are looking forward to helping elevate the strong support among small business owners in Vermont for Universal Health Care, among other issues.”
The group’s founding members include Liza Cain and Randy George, co-owners of Red Hen Bakery; Melinda Moulton, CEO of Main Street Landing; Trudy Trombley, owner of the Boutique at Stowe Mercantile; Stephanie Hainley, COO at White and Burke Real Estate Investment Advisors and former President of the Burlington Chapter of Business and Professional Women (BPW), and Wayne Nelson, partner at L.N. Consulting. They issued a joint statement saying, “We are excited to welcome Main Street Alliance to Vermont and to help elevate the voice of Vermont’s small businesses. We know that when we support our communities, we support our community businesses and we’re looking forward to making it easier for small businesses to join in these conversations in Montpelier.”
DesLauriers, comes to this role fresh from the 2014 Paid Sick Days Campaign, where she was the Campaign’s Director, employed by Voices for Vermont’s Children. “I’m so happy that I’ll be able to continue to work with the Earned Sick Days Coalition and local business owners to advocate for a standard of paid time in Vermont,” DesLauriers said. “As the Campaign Director for Paid Sick Days, it was my goal to address Vermonters’ real need for a standard of paid time in a way that makes sense for businesses and honors their leadership in policy development. We made a lot of progress last year and we’ll continue to work toward this goal in 2015.”
Main Street Alliance small business members have helped develop, support, and implement economy-boosting paid sick days laws in Seattle, Washington; Portland and Eugene, Oregon; Newark and Jersey City, New Jersey; and New York City.
Personally, DesLauriers grew up working and skiing at Bolton Valley Resort, which was owned and operated by her family until 1997. With both family and professional ties to the business community and the hospitality industry, DesLauriers describes herself as uniquely sympathetic to the challenges and responsibilities borne by small and mid-size businesses in Vermont. “Main Street Alliance is a great fit because both I and the organization as a whole are committed to the core values that will that will support and grow local businesses by supporting and building a robust economy for all Vermonters.”
Main Street Alliance creates opportunities for small business owners to speak for themselves to advance public policies that are good for small businesses, their employees, and the communities they serve. Vermont will be the 12th state affiliate.
As part of our founding work, the Vermont Main Street Alliance Outreach Team has been traveling across the state this summer speaking to hundreds of small business owners about a variety of statewide policies. The small business owners we’ve met have helped us to understand their concerns, they’ve shared their ideas, and they've shown tremendous support for a number of issues that we know will be addressed in the upcoming legislative session – including overwhelming support for the implementation of a universal, publicly-financed healthcare system in Vermont.
The owners we spoke to have shared that a universal healthcare system would remove a cost-burden from employers that many of them simply cannot afford. Even those who are providing insurance still struggle with the knowledge that, under the current system, many of their employees often can’t afford the co-pays and high premiums.
Additionally, many of the small business owners we’ve met have shared that the lack of affordable, high-quality childcare in Vermont has made it difficult to retain employees. They are keenly aware of how hard it is for Vermonters - owners and employees alike – to manage the demands of work with small children to care for. In some areas of our state, it is just plain hard to find reliable, high-quality childcare; where it is available, it’s hard to afford. We are learning that this is much more than an issue impacting low-income working families: the challenges posed by accessing childcare and the need to improve quality impact all of our families – owners and employees alike. Many of the businesses have even signed a statement of support for the efforts of Let’s Grow Kids, a public education campaign focused on the importance of early childhood.
But one of the most interesting and validating themes that has come up unsolicited again and again is that our main street business owners aren’t feeling represented by the larger business chambers – often both at the regional and state level. There is a feeling shared by many that the traditional chambers prioritize the interests of larger businesses, not always understanding the implications of how truly tied to the community locally owned small businesses are. The Vermont Main Street Alliance outreach team has been working hard to make these connections with real Vermont small business owners to help ensure that the voices and interests of small businesses are heard and represented.