Vermont Legislature SmartTranscripts:

[Alyssa Black (Chair)]: Thank you everybody. Sorry about the little break. So we're going to have Jen walk us through if we made any changes we may have made and get to ask any

[Jennifer Carbee (Office of Legislative Counsel)]: questions we want to ask. Well, good afternoon for the record. Jen Carvey from the Office of Legislative Counsel. I don't believe I have been with you on this bill since I did your initial walk through. So if you have changes you want to make, I need to know about.

[Alyssa Black (Chair)]: I have I have just failed, mister Kelly. I'm I'm not even going off the record to say this. I believe, well, we can discuss it as a committee and then maybe we can insert it if the consensus of the committee is that we'll add it. I don't think that it will take very long, and then maybe we'll take a short break. So we've made no changes. Do want you to put the bill up so we can see it? And I think I'm referring to the ability for this to be applied to deductible.

[Jennifer Carbee (Office of Legislative Counsel)]: And I think we had language that was presented to us around that. I think if I did look at some of what you had submitted to you, and I think the recommendation I'll look over to health traffic, its office was the language similar to what had been in 3002 last year. That would make some, give some clarification around cash price.

[Alyssa Black (Chair)]: Yep. And so let's just refresh ourselves on the bill and then we can look at that language and see.

[Allen "Penny" Demar (Member)]: Okay,

[Jennifer Carbee (Office of Legislative Counsel)]: great. So this is an act relating to establishing the Vermont Prescription Drug Discount Card program. It adds a new sub chapter in Title 18 and a chapter on prescription drug cost containment. Creating this program will be administered by the Office of the State Treasurer, and the purpose is to pool prescription drugs purchasing power with other US states and territories and non governmental organizations. The program would be available to all Vermont residents. It allows the treasurer to cooperate with other US states and territories, regional consortia or non governmental organizations or a combination of them to pool prescription drug purchasing power, reduce prescription drug costs, negotiate discounts with manufacturers, centralize purchasing and establish volume discount contracting. And then it defines volume discount contracting as the negotiated purchase of a large quantity of prescription drug at a decreased cost. It allows the treasurer to require reasonable fees to be charged to defray program costs. And it not withstands the statutory provision that says only the legislature can set fee amounts to allow the treasurer to determine the amount and method of collection of any fee based on actual costs. Starting on 01/15/2028, and annually thereafter, the treasurer would report to this committee, Senate Health and Welfare, and the Governor on the activities of the program during the previous calendar year, including how many Vermont residents and pharmacies participated in it and the amount of savings on prescription drug costs that was achieved. It establishes a fund, the Vermont Prescription Drug Discount Card Program fund as a special fund to be administered by the treasurer to support the program. The fund would consist of any monies appropriated to it by the General Assembly or transferred to it from the federal government, other state agencies, or other government source, any monies from the payment of fees or other monies due to the program, and any gifts, grants, or donations made or received by the treasurer for the program. Anybody who wants to give him money, it will take.

[Alyssa Black (Chair)]: And he's got a bank account to put it into.

[Jennifer Carbee (Office of Legislative Counsel)]: Directs the treasurer to credit all interest earned on the fund to unfunded balances to the Fund, as well as any other income derived from the deposit and investment of monies in the Fund, and it keeps the money in the Fund that remains at the end of the fiscal year. Section two is a report. By January 15, the Treasurer would report to the General Assembly on implementation of the program, including any recommendations for improving administration of the program, any fees to be charged to participants, and an estimate of the projected cost to the state in the event additional financial support is necessary to administer the program. Section three is what will send the bill to the Appropriations Committee before it goes to the floor. So this would have in fiscal year 2027, the sum of $50,000 appropriated from the general fund to the treasurer's office for the costs of developing and implementing the program as set forth in this act. And the act would take effect on 07/01/2026. Right.

[Alyssa Black (Chair)]: Any questions?

[Allen "Penny" Demar (Member)]: Yeah, go ahead. I don't know. Can't explain it. Two things, we've allowed any monies, fees, everything to go back into the program. And I don't expect this, but what if it becomes a large sum of money?

[Jennifer Carbee (Office of Legislative Counsel)]: Well, you can, I mean, one of the things you're getting an annual report on the program, so you could always change the amount, you know, you could, yes, you could limit the amount that could be carried over from year to year?

[Allen "Penny" Demar (Member)]: Should we get a report?

[Jennifer Carbee (Office of Legislative Counsel)]: You are getting a report.

[Allen "Penny" Demar (Member)]: Okay. Yep,

[Jennifer Carbee (Office of Legislative Counsel)]: you've got an implementation report, then you've an annual report starting in 2028.

[Allen "Penny" Demar (Member)]: Got another question, concern, because I'm here to represent Vermont. And I believe it said that anybody gives an address a It says

[Jennifer Carbee (Office of Legislative Counsel)]: it's made available to all Vermont residents.

[Allen "Penny" Demar (Member)]: Didn't they tell us the other day that this could go to anybody from

[Alyssa Black (Chair)]: If you had a Vermont address.

[Allen "Penny" Demar (Member)]: So my brother in California can give a Vermont address his birthday, and he'd be eligible for this card. Well, the

[Jennifer Carbee (Office of Legislative Counsel)]: program is available to all Vermont residents. So it will be up to the treasurer's office to determine who is a Vermont resident.

[Allen "Penny" Demar (Member)]: I think he told us that, did he remember hearing that, that a birthday and an address was sufficient to be on this program? Yes.

[Jennifer Carbee (Office of Legislative Counsel)]: It's my understanding, when somebody uses this card, it doesn't cost the state for them to

[Allen "Penny" Demar (Member)]: use So if it's

[Jennifer Carbee (Office of Legislative Counsel)]: issued to somebody who lives in California and used your address, I'm not sure there's a quantifiable

[Allen "Penny" Demar (Member)]: It really is, but it's a little, I guess, a pet peeve of mine that someone from Canada could get.

[Jennifer Carbee (Office of Legislative Counsel)]: Well, probably had a cheaper purchase of drugs in their own country, they could need it.

[Allen "Penny" Demar (Member)]: No, no, but that's the point. It's just the fact, when people know about this and it's out there.

[Alyssa Black (Chair)]: So right now, anybody with a Washington address can use it. Anybody with an Oregon address can use it, anybody with a Nevada address can use it. Connecticut, right. Connecticut can use it.

[Allen "Penny" Demar (Member)]: This says a Vermont resident, it's an address considered a resident.

[Alyssa Black (Chair)]: For the purposes of this program, the treasurer said that address It's

[Allen "Penny" Demar (Member)]: not going to stop me, but it's a concern. Getting else for a

[Alyssa Black (Chair)]: second way. More people that use it,

[Jennifer Carbee (Office of Legislative Counsel)]: Yeah. Figure your volume. I understand.

[Alyssa Black (Chair)]: Theoretically, the lower it would be for everyone. Deb? Does it actually

[Jennifer Carbee (Office of Legislative Counsel)]: be a physical address? It it can't be a PO box. Mhmm. It will be up to the to the way the Treasury Department implements it. The language of the statute says it will be made available to all Vermont residents.

[Alyssa Black (Chair)]: They don't usually make a PO box for an area. And that's the answer to the question.

[Allen "Penny" Demar (Member)]: If we stick to that, Vermont resident means living here, not using my address.

[Alyssa Black (Chair)]: What about if I go down to Florida for five months of the year?

[Allen "Penny" Demar (Member)]: Unless you declare yourself a Florida resident, you're still a Vermont resident. You're here. I mean,

[Jennifer Carbee (Office of Legislative Counsel)]: does not include a definition of Vermont resident, which we do use in some places, which is generally some version of being domiciled here with an intent to return here, coupled with an intent to return here, have temporarily absent and acts consistent with that intent. But I don't know if the treasurer's office is capable of that level of investigation on each applicant.

[Allen "Penny" Demar (Member)]: If you could make it simpler. It's okay. Wendy? I just had

[Alyssa Black (Chair)]: a question. If someone did get this card, it can only be used in the states that have this plan, correct? I can't use my card and go to Florida and say, Honor this card? I think it has to

[Jennifer Carbee (Office of Legislative Counsel)]: do with participating pharmacies? The pharmacies too are to participate. Okay.

[Alyssa Black (Chair)]: But it's not taking anything away from anybody else for somebody that may not be a resident. Not that I can see. I'm aware of?

[Allen "Penny" Demar (Member)]: See, it's just easier to put it in in the beginning and try to take care of it later on. I'm okay with it.

[Alyssa Black (Chair)]: Hopefully more states will get into this and everybody can use wherever they are and it won't matter.

[Allen "Penny" Demar (Member)]: Another concern. The state of Connecticut has only got 23,000 participants. That's not very big. So when we say hopefully all the states do this, that's going to be a long time coming.

[Alyssa Black (Chair)]: I think their controller indicated that they were hoping to see more uptick, and they are going to, I think he said that they are looking to do some advertising around it too. But the uptick has not happened because people aren't aware and this is why the treasurer has this $50,000 in there to make sure that Vermont residents know.

[Allen "Penny" Demar (Member)]: And my last concern, go ahead.

[Daisy Berbeco (Ranking Member)]: And AARP came in and said, we will help promote it. And I think there's been other folks that have said they'll

[Allen "Penny" Demar (Member)]: help promote this. My last concern, I'm reporting it. Okay.

[Alyssa Black (Chair)]: We're just asking. I'd to ask yourself something. A lot. I'd like to

[Allen "Penny" Demar (Member)]: You've answered. Okay. To me, it's going to be very confusing to a lot of people going to the drugstore. In other words, you're going to be in a drugstore and there's people behind you and you're going to say, Oh, what's my best way to pay for this? Cash or this card or my insurance card? The people that I know at home, they're not going to care. They're going throw their insurance card out there and that's the end of it. How many people are gonna get on that?

[Alyssa Black (Chair)]: Don't have their choice.

[Allen "Penny" Demar (Member)]: Yeah, I know, I know, but it's gonna be confusing. Go ahead.

[Lori Houghton (Member)]: But just that I think if that's the case, then maybe we and our colleagues have a duty to educate our constituents about how to maximize the benefits of this program. Just the message being, you want to save money, this is a way to save it. Say to your pharmacist, what's the cheapest way? It takes like five seconds. Dollars $5.10 this, okay? I think where it's confusing is how it applies to your deductible or not, and I would say have them call the healthcare advocate and work that out in advance. Call their office up, because they're really good at that stuff. They're really good at helping people save money.

[Allen "Penny" Demar (Member)]: A little confusing. The whole

[Lori Houghton (Member)]: system is. Sorry. Know what I'm gonna I'm gonna

[Alyssa Black (Chair)]: talk to Montgomery and I'm gonna help you use it. Yeah. Okay, Daisy.

[Daisy Berbeco (Ranking Member)]: Jenny, what is your number one goal this session?

[Allen "Penny" Demar (Member)]: Healthcare affordability. Listen, I'm reporting the bill, but I just, I've got concerns of all the bills. And you should,

[Daisy Berbeco (Ranking Member)]: and I think it's good to ask the questions. But I feel very strongly that this is critical for healthcare affordability for folks. If there's one chance that I can get my prescriptions, because I am on a lot of prescriptions, at a lower cost, I'm going to take it. I'm going to figure it out. And it's not like I'm getting a new prescription every month. Once I'm on something, I'm on it for a while. So I'm going to figure out which part is the lowest cost and I don't even have to do that once.

[Alyssa Black (Chair)]: I'm looking back at the treasurer's testimony and I can't remember, but I do think he made an estimate that it's in the millions of dollars that it could say Oh, is We have a representative Are any Yes. I can't remember the number, but is there an estimate of if we have sufficient uptick in this that

[Treasurer’s Office representative (name unknown)]: I don't remember the exact number, but it is up to a few million on behalf of all purchases, if you get a good rate of uptake. Oh, sorry.

[Alyssa Black (Chair)]: No, I was just going say, that's millions of dollars that stays in our constituents' pockets.

[Allen "Penny" Demar (Member)]: The other thing is, there are several of these cards that are already out there that people can take advantage of. It'd be like this, people with credit cards. Which one? Exactly.

[Alyssa Black (Chair)]: And Well, they can comparison shop. And as we learned from the treasurer, this is a nonprofit and it also does not sell your data, which cannot be said for a lot of the other prescription drug cards out there. Any other questions on this? Thank you for your question. Yes, so all questions answered, Allen?

[Allen "Penny" Demar (Member)]: Yes, So thank

[Alyssa Black (Chair)]: I believe in Charlie Becker's testimony, He had requested language around inserting into this bill to ensure that this will be applied, that people can And we heard Blue Cross say they do this all the time, that you could, if you wish, you can submit a claim to your insurance and it will be applied to your deductible So you're meeting like your out of pocket max or your deductible amounts. Is everyone in favor of inserting that language into the bill? Yep. Yes. Okay. All right. General have to do a new draft. And actually,

[Jennifer Carbee (Office of Legislative Counsel)]: I'm looking at some language because I think we may need to put it in two slices, and I'm not sure I can appreciate it.

[Alyssa Black (Chair)]: Do you need time? You're gonna need time.

[Jennifer Carbee (Office of Legislative Counsel)]: But you're taking some testimony this afternoon that I was gonna be here just to listen to. Okay. So I can work on

[Alyssa Black (Chair)]: it. So let's see. We don't have our next witnesses until 02:00. I think I'm just gonna I think I'm gonna take a break until Jen either finishes or until 02:00. Our next witnesses are not here yet. It won't be long, right? They're scheduled at two. Okay. Okay.

[Lori Houghton (Member)]: So we could have a break from five to thirty minutes depending on when Jen finishes.

[Jennifer Carbee (Office of Legislative Counsel)]: Yes. Yes. No pressure. So should I go outside the Sorry.

[Lori Houghton (Member)]: Didn't mean it that way.

[Alyssa Black (Chair)]: The nurse anesthetist that maybe he just confirmed.

[Allen "Penny" Demar (Member)]: Let me go back to

[Alyssa Black (Chair)]: Yeah. Let's go off of

[Allen "Penny" Demar (Member)]: live

[Alyssa Black (Chair)]: and