Early Friday morning, the 2017 legislative session finally adjourned, nearly two weeks later than the early May target set by the leaders in the House and Senate. Legislators are scheduled to come back to Montpelier on June 21 for a "veto session." Governor Scott has promised to veto the budget because legislators failed to adopt his plan for a statewide teacher health insurance plan.

I am pleased to report that the final budget and tax bills include a new home health provider tax formula supported by the VNAs of Vermont and a two percent Medicaid increase for VNAs across all programs, including Choices for Care, skilled home care and hospice services. The VNAs of Vermont are very grateful to the House and Senate for supporting these provisions. While a budget veto and subsequent budget renegotiation could impact these provisions, I am optimistic that they will be preserved regardless of other changes.

Like all provider groups, VNAs have an uneasy relationship with the provider tax. Each time the tax formula is adjusted, some VNAs benefit and some VNAs are hurt because the Administration and budget writers always insist on raising the same amount of revenue. The tax was originally passed as a mechanism to draw down federal matching dollars to fund annual inflationary rate increases. Over the past decade, Medicaid rate increases have been few and far between and instead, the dollars raised by the tax have funded higher caseloads. Between the losses that VNAs incur under all Medicaid programs and a decade of federal cuts to Medicare reimbursement, this has become increasingly untenable. The position of the VNAs of Vermont is that if the provider tax is going to continue, it should be paired with an annual inflationary Medicaid increase. The budget bill does not include language supporting an annual inflationary increase. That's an issue we will continue to press in future years so we can continue to provide high-quality, low-cost care to Vermonters.