MONTPELIER — Newly inaugurated Vermont Gov. Phil Scott took office Thursday, bringing with him a new roster of officials who will decide the direction of Vermont’s health care.
The administration will include several new faces and a new title for a key player held over from the previous regime.
Al Gobeille, chair of the Green Mountain Care Board under outgoing Democratic Gov. Peter Shumlin, will serve as secretary of Human Services under the Republican Scott.
When asked about the difficulty of serving under governors with conflicting health care views, Gobeille told Watchdog, “I think (the transition) will be really easy. Scott allows you your day in court; he doesn’t just make decisions. We’ll be able to work together, and that’s a healthy way to lead.”
John McClaughry, vice president of the Ethan Allen Institute, a free-market think tank that opposed the all-payer model the board rushed to approve by the end of last year, also is optimistic about Gobeille’s new role.
“He’s as respectable a person as you can have. The Agency of Human Services is a nightmare, and I’m eager to see him get the chance to clean it up.”
Though Gobeille played a key role in the all-payer model’s development, McClaughry said Gobeille was doing his best to follow instructions coming from the governor and Legislature, which is the job of the Green Mountain Care Board.
“I think he had the wrong assignment,” McClaughry said. “(In his new role) I hope he can orient the government toward an open-market approach.”
At AHS, Gobeille will have more freedom of action than he did when relying on specific directives from the Legislature.
“I get to be a part of a great team, with the ability to be really creative and execute goals within that space,” Gobeille said.
One of his first acts as Secretary of Human Services will be to prepare a briefing for Scott and the Legislature on Strategic Solutions’ newly released study determining the feasibility of Vermont Health Connect. The study recommended continuing with the state exchange, yet Gobeille claims details of the report don’t support that conclusion.
Strategic Solutions was commissioned by the House in April to conduct an independent study of Vermont Health Connect. The company, however, is hired to fix broken exchanges, a conflict of interest Gobeille says cannot be ignored.
“Never ask a barber if you need a haircut,” he said. “The headline of the report is not supported by the actual content. … When you read the report, it’s not clear that the present exchange should be continued.”
Gobeille says that in the upcoming report, AHS will evaluate each separate section of Vermont Health Connect’s systems and technology to see which parts should be saved and which should be thrown out.
Scott is bringing in a new talent to help the state manage the exchange.
Cory Gustafson is leaving the private sector to serve as commissioner of the Department of Vermont Health Access. Having previously served as director of government and public relations at Blue Cross Blue Shield of Vermont, Gustafson is well acquainted with the insurance company’s troubles with Vermont Health Connect.
The exchange’s flawed data sharing led to delayed and incorrect patient billing that resulted in Vermont owing millions in back payments to BCBS.
For his first job on the government side of things, Gustafson takes the reins of a department responsible for managing Vermont’s publicly funded insurance programs.
“I hope he has the talent to sort through the mess he’s inherited,” McClaughry said.
Gustafson did not respond to Watchdog’s interview request.
On Thursday, Betty Rambur announced her resignation from the Green Mountain Care Board. Along with Gobeille’s departure, this leaves two big holes for Scott to fill.
“From our perspective, it is critical that the board have an M.D. physician, ideally one who understands the needs of private practice,” Amy Cooper, who represents independent doctors through the advocacy group Health First, told Watchdog.
Dr. Allan Ramsay, the board’s only practicing physician, retired in September 2016. Shumlin replaced him with Robin Lunge, former director of health care reform for the Agency of Administration.
According to Cooper, Lunge is not a practitioner and therefore lacks the experience of seeing how policies impact doctors and nurses in the field.
“We were shocked to see this replacement for Allan Ramsay,” Cooper said. “We see this new vacancy as an opportunity for the governor to appoint a doctor, solidifying the credibility of the board in the eyes of Vermont doctors.”
Lunge’s appointment to the board leaves her old position, director of health care reform, vacant. Ethan Latour, Scott’s assistant director of policy and communications, told Watchdog that the governor intends to dissolve the department of Health Care Reform as it currently exists.
Latour said the position of chief of health care reform will continue, but will move to the Agency of Human Services, where the new appointee will “work alongside (Gobeille) on the state’s health care policy.”
The department of Health Care Reform previously operated under the Agency of Administration, with the goal of coordinating reform efforts through various government departments. Working in this department, Chief of Health Care Reform Lawrence Miller oversaw the operation of Vermont Health Connect, the state’s troubled state insurance exchange.
Latour did not comment on whether Miller’s position will continue in the restructured system. His position is likely dependent on whether decision makers want to continue operating the exchange or scrap it for another option. Scott is expected to speak about the future of Vermont Health Connect during his budgetary address later this month.