MONTPELIER — Gov. Peter Shumlin said Friday he will scrap a $4.9 million budget-savings initiative he proposed just one day earlier that would have changed Medicaid eligibility requirements for pregnant women.
Shumlin, who delivered his final budget address to the Legislature Thursday, had planed to raise the income level at which pregnant women qualify for the Medicaid from 138 percent of the federal poverty level to 213 percent. That equates to about $16,000 and $25,000, respectively.
Women who no longer qualified for Medicaid under the governor’s proposal would have been eligible for subsidized health plans on Vermont Health Connect, the state’s online health insurance marketplace. A change in state law would be required, however, to allow pregnant women to enroll in a health plan outside of the open enrollment period.
But Shumlin took Montpelier by surprise Friday when he said on Vermont Public Radio’s Vermont Edition that he was abandoning the idea — less than 24 hours after proposing it.
“I don’t want to use this as a way to cost pregnant women more money,” the governor said on the program. “I said to my team this morning, ‘Listen there’s plenty of ways to save money in the budget. Go back to the Legislature and give them alternatives of other ways to make savings.’”
The quick reversal came after Shumlin faced heavy push back from Democratic House Speaker Shap Smith.
“Even before the budget speech I did call the governor and expressed my strong reservations about the proposal. My concern was that we all know prenatal care is critically important and I didn’t want there to be anything that might restrict access or cause poor, pregnant women to decide that they weren’t going to seek care,” Smith said. “My specific concerns were that putting them on the state exchange would require them to, one, pay premiums that they couldn’t afford, and two, that they might have to pay co-pays and deductibles that would prevent them from seeking care.”
Smith said he did not threaten the governor with coming out against the proposal if the administration continued to push it.
“My guess is that in my conversations with the governor … it was pretty clear how I felt,” the speaker said. “He said he would take a look at it. I think he appreciated the fact that I was willing to check in with him. It’s always been my preference in working with the governor to express my concerns that I have privately with the governor. I think he appreciated the fact that I gave him a heads up on it.”
The governor’s proposal to change the Medicaid eligibility was part of a budget plan that raises $30 million in revenue and reduces spending by $38 million to balance the 2017 fiscal year budget.
Shumlin spokesman Scott Coriell said the plan outlined by administration officials Thursday provides a benefit to pregnant women of all income levels because it would begin to classify pregnancy as a life event that allows mid-year enrollment in health insurance coverage.
“The proposal we laid out makes pregnancy a qualifying event so women can sign up for health care when they get pregnant. This will help any woman — regardless of whether they qualify for Medicaid — who is uninsured and becomes pregnant. That was the initial policy decision that we’re still moving forward with,” Coriell wrote in an email.
The state, several decades ago, put in place eligibility requirements that allows pregnant women with slightly higher income levels to receive Medicaid coverage during pregnancy. However, Medicaid coverage ends for women with the slightly higher income when they are no longer pregnant.
Coriell said the administration’s proposal was intended to ensure the continuity of care by ushering pregnant women in that income bracket to the exchange instead of Medicaid. It would have raised the cost of insurance for about 300 women, however.
“Under that system, those women have Medicaid coverage for the 9 months they are pregnant but lose it as soon as they give birth. Because our proposal makes becoming pregnant an event which qualifies women to sign up for insurance — with access to subsidies, etc. — it essentially made the old policy duplicative. So when the budget was being put together, we booked savings by ending the old policy. We now realize that could have an unintended consequence on a very small group of women, so we have decided not to ask the Legislature to do that. We will find savings elsewhere.”