Introduced by Representatives Kiss of Burlington, Atkins of Winooski, Cross of Winooski, Donovan of Burlington, Edwards of Brattleboro, Fisher of Lincoln, Haas of Rochester, Keenan of St. Albans City, Larson of Burlington and Zuckerman of Burlington
Subject: General assembly; executive branch; administrative procedure; economic impact statements; fiscal impact statements
Statement of purpose: This bill proposes to: (1) require the joint fiscal office to prepare a fiscal impact statement for proposed legislation which enacts or amends Medicaid policy, benefits, or eligibility; (2) require the executive branch to prepare an economic impact statement for each proposed rule which shall analyze impacts on recipients of health care services, as well as impacts on business activity, employment, and employee earnings in the state; (3) allow the legislative committee on administrative rules to object and certify its objection to a final proposed rule if it determines that an agency’s economic impact statement fails to recognize a substantial economic impact of the rule; (4) require legislative approval before application for a waiver or amendment to the state Medicaid plan; and (5) require the secretary of human services to report on all employers who employ individuals who are beneficiaries of state health or medical programs.
AN ACT RELATING TO FISCAL AND ECONOMIC IMPACT STATEMENTS FOR MEDICAID CHANGES
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 2 V.S.A. § 207 is added to read:
§ 207. ENACTMENT OR AMENDMENT OF MEDICAID LAWS; FISCAL
IMPACT STATEMENTS REQUIRED
(a) Prior to a standing committee’s proposing the enactment or amendment of a state law affecting Medicaid policy, benefits, or eligibility, the joint fiscal office shall prepare a fiscal impact statement which analyzes fiscal impacts of the proposed legislation. State agencies shall assist the joint fiscal office as required by that office.
(b) The fiscal impact statement shall analyze the impacts of proposed legislation on recipients of health care services, as well as the impacts on business activity, employment, and employee earnings in the state. As used in this section:
(1) “Business activity” means the overall level of output of goods and services in the state.
(2) “Employee earnings” means wage and salary income associated with new jobs created or lost in the state.
(3) “Employment” means the number of new jobs created or lost in the state.
(c) The appropriations and capital budgets of the legislative session in which Medicaid policy, benefits, or eligibility is enacted or amended shall be reflective of, and give full consideration to, the fiscal impact statement required by this section.
Sec. 2. 3 V.S.A. § 838(c) is amended to read:
(c)(1) The economic impact statement shall analyze the anticipated costs and benefits to be expected from adoption of the rule. Specifically, each economic impact statement shall, for each requirement in the rule:
List categories of people, enterprises, and government entities
potentially affected and estimate for each the costs and benefits anticipated ;. (2)(B) compare
Compare the economic impact of the rule with the economic impact of
other alternatives to the rule, including no rule on the subject or a rule
having separate requirements for small business ;. (3)(C) include
Include a flexibility statement. The flexibility statement shall
compare the burden imposed on small businesses by compliance with the rule to
the burden which would be imposed by alternatives considered under section 832a
of this title.
(2) In addition, each economic impact statement shall conclude that the rule is the most appropriate method of achieving the regulatory purpose and, with respect to small businesses, contain any findings required by section 832a of this title. Only employees of the agency and information either already available to the agency or available at reasonable cost shall be used in preparing economic impact statements.
(3) In addition, the department of prevention, assistance, transition, and health access or its successor agency shall specifically analyze the impacts of the proposed rule on recipients of health care services, as well as the impacts on business activity, employment, and employee earnings in the state. As used in this section:
(A) “Business activity” means the overall level of output of goods and services in the state.
(B) “Employee earnings” means wage and salary income associated with new jobs created or lost in the state.
(C) “Employment” means the number of new jobs created or lost in the state.
Sec. 3. 3 V.S.A. § 842 is amended to read:
§ 842. REVIEW BY LEGISLATIVE COMMITTEE
(a) Within 30 days of the date a rule is first placed on the committee’s agenda but no later than 45 days after the filing of a final proposal unless the agency consents to an extension of this review period, the legislative committee on administrative rules, by majority vote of the entire committee, may object under subsections (b), (c), or (d) of this section, and recommend that the agency amend or withdraw the proposal. The agency shall be notified promptly of the objections. Failure to give timely notice shall be deemed approval. The agency shall within 14 days of receiving notice respond in writing to the committee. After receipt of this response, the committee may withdraw or modify its objections.
(b)(1) The committee may object under this subsection if:
proposed rule is beyond the authority of the agency; (2)(B) a
proposed rule is contrary to the intent of the legislature general
assembly; (3)(C) a
proposed rule is arbitrary; or (4)(D) the
agency did not adhere to the strategy for maximizing public input prescribed by
the interagency committee on administrative rules; or
(E) the economic impact statement fails to recognize a substantial economic impact of the final proposed rule.
objection is made under this subsection, and the objection is not withdrawn
after the agency responds, on majority vote of the entire committee, it may
file the objection in certified form with the secretary of state. The
objection shall contain a concise statement of the committee’s reasons for its
action. The secretary shall affix to each objection a certification of its
filing and as soon as practicable transmit a copy to the agency. After a
committee objection is filed with the secretary under this subsection, or on
the same grounds under subsection 817(d) of this title, to the extent that the
objection covers a rule or portion of a rule, the burden of proof thereafter
shall be on the agency in any action for judicial review or for enforcement of
the rule to establish that the part objected to is within the authority
delegated to the agency, is consistent with the intent of the
general assembly, is not arbitrary, and the agency did adhere to
the strategy for maximizing public input prescribed by the interagency
committee on administrative rules, or the economic impact
statement does not fail to recognize a substantial economic impact of the final
proposed rule. If the agency fails to meet
its burden of proof, the court shall declare the whole or portion of the rule
objected to invalid. The failure of the committee to object to a rule is not
an implied legislative authorization of its substantive or procedural
(c) The committee may object under this subsection if a proposed rule is not written in a satisfactory style according to section 833 of this title.
committee may object under this subsection if the economic impact statement
fails to recognize a substantial economic impact of the proposed rule that the
committee describes in its notice of objection. The committee may object one
time under this subsection and return the proposed rule to the agency as
unacceptable for filing. The agency may then cure the defect and adopt the
rule, or it may adopt the rule without change. (e) When
an objection is made under subsection (b) of this section and has been
certified by the secretary of state, notice of the objection shall be included
on all copies of the rule distributed to the public.
Sec. 4. 33 V.S.A. § 1901(a) is amended to read:
(a) The commissioner shall take appropriate action, including making of regulations, required to administer a medical assistance program under Title XIX of the Social Security Act. However, any waiver or amendment to the state plan shall be approved by the general assembly prior to application.
Sec. 5. 3 V.S.A. § 3022 is amended to read:
§ 3022. BUDGET AND REPORT
secretary shall be responsible to the governor and shall plan, coordinate and
direct the functions vested in the agency.
He The secretary shall
prepare and submit to the governor an annual budget and shall prepare and
submit to the governor and the general assembly in November of each year a
report concerning the operations of the agency for the preceding fiscal year
and the future goals and objectives of the agency.
(b)(1) Annually, on February 1, the secretary shall submit a report to the house and senate standing committees with jurisdiction over health matters and financing matters. The report shall provide the following information for each employer of 20 or more persons who are beneficiaries that receive medical assistance, medical benefits, or health care services from or through the agency of human services:
(A) the name and address of the employer;
(B) the number of beneficiaries who are employees of the employer;
(C) the number of beneficiaries who are spouses or dependents of employees of the employer;
(D) whether the employer offers health or medical benefits to its employees; and
(E) the cost to the state of providing health or medical benefits for their employees and their spouses and dependents.
(2) The report shall not include the names of any individual beneficiary and shall not compromise the privacy of a beneficiary in any other way.
The Vermont General Assembly
115 State Street