Hogan: The Fisher Ruling

Aug 1, 2018

I was a member of the original Green Mountain Care Board, put in place in 2011, where I served the maximum term of six years.

And I must admit I’m chagrined at the decision to bar Michael Fisher, the head of Vermont’s health care consumer advocate office, from testifying at the insurance rate hearings.

He was evidently ruled out because MVP and Blue Cross petitioned the Green Mountain Care Board with the view that he didn’t have the required expertise to testify. And the Board agreed. But this doesn’t make sense to me, since the same ruling could have been made about my expertise.

I was in government for many years as Secretary of Human Services, and had learned a lot about health care in Vermont, but I had very little knowledge about the actuarial detail of insurance rate filings or the inner workings of the work of the insurance companies.
In fact, I knew less then than Michael Fisher knows now.

I should add that Mr. Fisher isn’t a rookie in the health debate. He was a legislator for many years and served as the Chair of the Health Care Committee in the House. His background is solid.

Affordability was one of the main thrusts of Act 48, which established the Green Mountain Care Board. And I should think that the Board would want all possible feedback. And, after all, the health care advocates’ office was established by the state specifically to help make health care costs more “affordable”.

This unfortunate ruling has the effect of limiting the kind of feedback the Board needs in making their decisions. It allows the insurance companies to define “affordable” according to their particular view, resulting in an overall less balanced view than one that also took in the view of consumers.

And this could be a slippery slope.

Based on the current decision to bar Mr. Fisher from testifying, it wouldn’t surprise me if the insurance companies petitioned to limit the testimony of individual members of the public at large, claiming that they do not have the expertise to testify.

Both MVP and Blue Cross have served Vermonters well over these difficult years of health reform. But concerning this decision, I hope the Board re-considers.

Editor's note: VPR has learned the GMCB had no discretion in its ruling. The terms of the hearing are prescribed by precise law and include the definition of an expert. However, the commentator further wishes to observe that under the terms of the existing law it is difficult – perhaps impossible - to see how the interests of the public regarding affordability could be fully balanced with the interests of the insurance companies.