BRATTLEBORO -- Vermont came out on top in a series of last minute provisions that were negotiated this weekend as the Senate worked to get its health care bill approved before Christmas.
Windham County could be home to the state’s newest community health center, after Sen. Bernard Sanders, I-Vt., was able to increase the health center funding in the final version of the Senate health care bill that passed early Monday morning.
"One of the reasons I voted for the Senate bill was that we were able to get in an ammendment for $10 billion over five years to expand community health centers and the National Health Service Corps," said Sanders on Monday.
The new centers are expected to provide primary care for 45 million people, up from the current level of 20 million.
In the House, the proposal for funding for community health care centers is $14 billion, said Sanders.
If it is appropriated, said Sanders, it will increase the number of Americans with access to community health care centers from 20 million to 45 million over five years.
For Vermont, that will mean adding health centers to Addison and Bennington counties and "if there is an interest, Windham County as well," said Sanders.
Currently, Vermont has eight community health care centers with 40 satellite locations. The closest to Windham County is in Springfield, which was established with federal stimulus funds.
With 110,000 participants, said Sanders, Vermont has the highest level of participation per capita in community health care than any other state.
Sen. Patrick Leahy, D-Vt., was able to increase Medicaid payments to the state by $250 million over six years after convincing lawmakers to include the extra funding in an amendment to the Senate bill.
The late Sen. Edward Kennedy, D-Mass., wrote the legislation that established Federally Qualified Health Centers 40 years ago, and about 20 million Americans receive primary health care, dental care and mental health services at the centers.
The cost of care at the health centers runs about 41 percent less than what is spent elsewhere, Dan Hawkins, senior vice president of the National Association of Community Health Centers told Congress earlier this year.
And Sanders said the centers also save money by delivering primary care early on and keeping patients out of the emergency room.
A study conducted by George Washington University found that caring for more patients in the community health centers could save Medicaid $23 billion over five years on reduced emergency room use and hospital costs.
Vermont has eight community health centers and 40 satellite offices which provide acre to 100,000 patients, regardless of their ability to pay.
Sanders worked to increase the investment in the community health centers from $10 billion to $14 billion, which is expected to more than double the number of centers across the nation over the next five years.
Leahy was also able to include the increase in Medicaid payments during intense negotiations this weekend as Senate Majority Leader Harry Reid, D-Nev., worked to get a vote on the final bill before the Christmas recess.
The Senate’s bill requires states to expand their Medicaid programs, but Vermont has already expanded its coverage.
Leahy and Sanders argued that Vermont would be penalized for already expanding its program and Leahy was able to convince Reid to include the $250 million, which will be delivered to Vermont between 2014 and 2019.
"Vermont has always been a national leader in expanding access to health insurance, and that is something that any health reform plan should reward and not punish," Leahy said in a press release. "This formula adjustment will ensure that Vermont is not disproportionately burdened by a further expansion of the Medicaid program. This is a major improvement in the bill for Vermont. Majority Leader Reid has kept his word in working with us to fix this unintended loophole."
The health care legislation that has been the focus of partisan debate inched closer to passing Monday when all 58 Democrats and the Senate’s two independents voted in favor of the most recent version.
Reid cut numerous last-minute deals to get the votes he needed and powerful Democrats also inserted home-state provisions in a 383-page package of amendments Reid filed this weekend to the 2,074-page bill.
A number of other procedural votes are scheduled today and Wednesday, with a final vote expected on Christmas Eve.
A number of major differences between the Senate and House versions will have to be worked out in committee after Christmas before the bill is sent to President Barack Obama for approval.
The Associated Press contributed to this report.
Howard Weiss-Tisman can be reached at firstname.lastname@example.org or 802-254-2311, ext. 279.