Vermont’s Single-Payer Healthcare is Good Medicine for NH Economy
The New Hampshire Union Leader originally published this column on April 13, 2012:
While the majority of states is trying to block Obamacare, Vermont is doing just the opposite. Vermont Gov. Peter Shumlin doesn’t think Obamacare went far enough, so Vermont is implementing a government-driven, single-payer health insurance system instead. This could become good news for New Hampshire.
Almost lost in the hubbub of last month’s U.S. Supreme Court case about Obamacare was the reason everyone was in court in the first place. Yes, the 28 states that sued the federal government to overturn the Affordable Care Act are controlled by conservatives who oppose Obamacare on philosophical grounds and made constitutional arguments against it. But the main reason the states went to court is because of the impact Obamacare would have on state budgets.
Obamacare is guaranteed to make state budgets sick by expanding Medicaid, the taxpayer-subsidized health insurance program for the poor and disabled that is the largest single line item in most state budgets. Grow Medicaid and you blow a hole in state and county budgets, which are responsible for more than half of Medicaid funding and, unlike the feds, cannot run deficits to pay for it.
New Hampshire Gov. John Lynch, who knows better, has ignored this basic fact for partisan reasons. New Hampshire was not among the states in court last month, though it should have been.
Neither was Vermont, but for different reasons. Last year Vermont adopted Green Mountain Care, a government-run, single-payer health insurance program pushed by Gov. Shumlin that goes well beyond Obamacare. This month the Vermont Legislature is finalizing a state health insurance exchange as an interim step to implementing Green Mountain Care. Should the Court strike down Obamacare, Vermont’s experiment will proceed anyway.
This is where Vermont starts driving its businesses into New Hampshire’s arms. Vermont passed Green Mountain Care without deciding how to pay for it. New and higher taxes are coming to Vermonters, most likely on businesses. Individuals and small businesses are being forced to give up their existing health insurance plans and must participate in the exchanges, where they will have to choose among a very small number of higher-priced, government-approved options. Private, alternative plans operating outside the exchange will be prohibited, destroying the private market.
Remember when President Obama promised, “If you like your health care plan, you can keep your health care plan?” Not in Vermont, which he carried by 37 points in 2008.
What’s a small but growing Vermont business to do? Some will move, or at least hire new employees out of state. For many of them, getting over the Connecticut River is not a bridge too far. Recall how C&S Wholesalers largely migrated from Brattleboro to Keene when Howard Dean was governor in the 1990s.
Green Mountain Roasters, booming with nearly 1,000 employees, could end up in the White Mountains. Ben & Jerrys and Cabot Cheese may be iconic Vermont brands, but that doesn’t mean their headquarters can’t shrink as new employees are hired across state lines.
Vermont’s largest private employer, IBM, has around 5,000 people in Essex Junction, near Lake Champlain. Even though IBM is self-insured and thus exempt from the changes, the corporation could still end up being taxed to pay for everyone else’s coverage. Those jobs could very easily migrate down I-89 to Lebanon.
Of course, not every business can move. It’s especially hard to move mountains like Stowe or Killington, whose ski resorts are major private employers. It would take a long time to move the Rock of Ages quarry from Barre to Bath, one stone at a time. Likewise hospitals, which employ hundreds.
Everything else is fair game, and poaching Vermont businesses should be on the agenda of New Hampshire’s next governor. Just as Wisconsin and Indiana are taking advantage of Illinois’ dysfunctional state government — Indiana Gov. Mitch Daniels says it’s like living next door to the Simpsons — New Hampshire can rename Gov. Shumlin as the Granite State’s honorary Commissioner of Economic Development.
New Hampshire’s next governor could even erect billboards in Vermont saying, “Had enough? Call me.” Except, of course, that billboards are prohibited in Vermont. When it comes to big government, at least they’re consistent.
Fergus Cullen, a freelance columnist, can be reached at firstname.lastname@example.org.