Included within the recently passed health care law is a provision that allows states to propose their own pilot health care programs and seek a waiver from the federal health care law so that they can pursue their own approaches to health care reform. The current law allows states to pursue these waivers in 2017. Yesterday, Rep. Peter Welch (D-VT) introduced an amendment to the law that would move this waiver date up to 2014, and he instantly received support from his fellow Vermont public officials Sens. Bernie Sanders (I-VT), Patrick Leahy (D-VT), and Gov. Peter Shumlin (D-VT). There is also support in the Senate for moving the waiver date forward, in the form of an amendment introduced by Sens. Scott Brown (R-MA) and Ron Wyden (D-OR).
Earlier today, ThinkProgress attended a meeting with Democratic House members and asked them about their plans to respond to the Republican push to repeal health care and about their thoughts on Welch’s legislation. Two members of Congress, Reps. Jan Schakowsky (D-IL) and Jim McDermott (D-WA), explictly endorsed Welch’s proposal. Schakowsky told ThinkProgress that she “absolutely” supports the Welch proposal and that Republicans “ought to be for” it because they claim to believe in “states’ rights”:
THINKPROGRESS: [Welch] had mentioned along with the rest of the delegation of Vermont that they’re actually looking at moving the waiver of letting state’s pursue their own health systems from 2017 to 2014 to allow Vermont to pursue sort of a single payer style approach. Would you support moving that waiver?
SCHAKOWSKY: Absolutely. I think that all of the leadership now in Vermont, here in the House, Senate, the Governor had a press conference together in order to do that. Let Vermont show us the way to a single payer system. The former governor was on television last night, Howard Dean, talking about that as well. I think we should be able to experiment. We should give states the option. Republicans ought to be for that. States’ rights, experiment with their own plans, and do a single payer.
McDermott told ThinkProgress that he “of course” supports the Welch proposal. He explained that he had tried to get a single payer system enacted in 1985 in Washington state, but that federal insurance laws prevented him from doing so. He said that “state by state implementation is probably the best way to go”:
THINKPROGRESS: You mentioned earlier that you were a single payer advocate, states like Vermont or maybe California, may move ahead and implement state based programs like that, but they need a waiver from the federal government; the current waiver kicks in at 2017, some members are trying to push that waiver forward and implement those systems in 2014, would you support that?
MCDERMOTT: Of course. I basically tried to do that in the state of Washington in 1985. But the problem at that point was you couldn’t get everybody in the state into it because of ERISA. [...] The big companies use ERISA as their protection, they were not willing to allow the state of Washington to develop their own plans. I watch what happened in Canada in ’67 when Tommy Douglas put the program together in Saskatchewan. My view is that state by state implementation is probably the best way to go.
Meanwhile, at least two members of the Democratic leadership — House Democratic Steering and Policy Committee Co-Chair Rep. Rosa DeLauro (D-CT) and Assistant Minority Leader Rep. James Clyburn (D-SC) — expressed positive support for Welch’s idea without explicitly endorsing his amendment. DeLauro told ThinkProgress that we should “talk about” Welch’s amendment and that she’s never said that states shouldn’t be able to go forward with their own plans if they have “a better plan.” When asked if that meant she thought Welch’s idea was a good idea, she replied that it “does” sound like a good idea:
THINKPROGRESS: Let’s say a state like Vermont, Congressman Welch’s state, have a plan that is more progressive, that meets all the requirements of the Affordable Care Act, but is maybe more efficient, covers more people, is more comprehensive, right now a state like that can request a waiver to do their own health care system but they have to wait until 2017. Congressman Welch is proposing we move that to 2014, so that maybe they can move forward.
DELAURO: Let’s talk about it. Where you have more progressive plans. I have said I’ve never been one to say we ought to we shouldn’t if a state has a better plan, whether that’s on food safety, or health care, that we shouldn’t do is to lower the standards. The standards should always be raised in these arenas.
THINKPROGRESS: So it sounds like you’re saying it’s a good idea.
DELAURO: It does. Let’s see what the fish hooks are, let’s see what the benefits are. And let’s have a debate about it. About the principle of it needs to be what we’re dealing with here and how we can make this piece of legislation a stronger piece of legislation. No one has ever said that this is it, it’s cast in concrete and that’s it we’re not moving on. It would be foolish to do that.
Meanwhile, Clyburn told the blogger meeting that there is a precedence for states opting out of federal laws if they can meet the minimum requirements or exceed them, citing the case of South Carolina, which opted out of certain provisions of the Civil Rights Act because it exceeded the requirements. Clyburn appeared to use the analogy to support Welch’s idea, asking rhetorically, “What’s wrong with that?”
– Zaid Jilani and Kevin Donohoe
A report commissioned by the legislature of the state recommended yesterday that Vermont pursue a single payer system.