by Hamilton E. Davis
The last few weeks have offered at least some surcease from the gut-wrenching tensions of a toxic political year. Donald Trump still prowls the land, of course, but at least he’s not in office yet, and perhaps Congressional Republicans can summon up enough political courage, modest intelligence and common decency to keep him in check.
Vermont, meanwhile, has been an island of relative political tranquility. Phil Scott will be our new governor. He is a Republican, but he can fairly be described as the “un-Trump.” He can’t start a war, trade or otherwise, with China. And while he doesn’t have much of a state issue profile beyond budget discipline, he doesn’t have a mean bone in his body. He is even leaving the door open to continued progress on the health care reform project he is inheriting from Peter Shumlin.
So it seems like a not-bad time to look forward to Vermont’s political environment as we approach the 2017 legislative session. A defining parameter is that Democrats still control both the House and Senate. They also hold the Congressional delegation and all the state-wide offices below governor. As governor, Scott can veto bills, and he controls the bureaucratic machinery of government so there is muscle on both sides, but the issue environment is very fluid.
Budget issues will be important, as always, but there isn’t much running room there for anybody. Money is just too tight. The elementary and secondary school issue will continue to fester, and there will be some pressure to make progress on environmental issues like cleaning up Lake Champlain.
By far the most important issue, however, is health care reform. I know that health care is my particular hobby horse, but I refuse to apologize for that. Vermonters spend one dollar in every five they earn on health care; and beyond money, their lives often literally depend on it. Barrels of digital ink have been spilled on it, but there have been some striking developments recently in that sandbox, one of which I want to discuss today.
The news I have in mind is the decision by Sen. Tim Ashe, the Chittenden County Democrat who will take over that chamber in January as President Pro Tem, to hire Peter Sterling to be his legislative assistant. There is a remarkable paucity of staff in Vermont’s legislative structure, and staff issues almost never make news. In this case, Sterling is very important news indeed.
The reason is that Sterling is far outside the normal pattern for this kind of job. These posts are normally—I am tempted to say always--filled by young, bright, inexperienced people who like politics and government and are looking for a place to get started. They don’t get paid much, and they pretty much do everything: answer the phone, get coffee, write press releases, offer advice to the boss, and soak up the political and legislative atmosphere.
After this sort of apprenticeship, they move up at the first opportunity. The pattern is evident in the Vermont State House today. For example, Rachel Feldman has served for the last few years as assistant to Phil Scott during his tenure as lieutenant governor. When Phil’s transition office opened, one of the first appointments to his gubernatorial staff was Rachel Feldman. Another: Dylan Giambatista spent a couple of sessions as assistant to House Speaker Shap Smith. With Smith retiring, Giambatista ran for Vermont House seat and won; he’ll take office for the first time in January.
Sterling, by contrast, is not just experienced. He is one of the very best health policy experts in Vermont. When Steve Kimbell, who along with Anya Rader Wallach put the Shumlin health care reform team together in 2011, tried to recruit Sterling, Sterling declined. He opted instead to run his own reform advocacy group to support the Shumlin project. As everyone knows, Shumlin’s path toward reform was rocky indeed; but on several occasions when the Governor needed help persuading the public on some aspect or other, he called on Sterling to speak in its favor.
A personal note: I have followed the health care reform issues in Vermont since the early 1980s, and if I had to find an SUV load of the most knowledgeable health policy experts in Vermont—say, seven or eight people—Sterling would be there.
Sticking with the SUV analogy as a way to limn the policy landscape: The Scott administration will have Al Gobeille, the Secretary-to-be of the Agency of Human Services; the Green Mountain Care Board has Ena Backus, Gobeille’s current deputy; The Vermont Medical Society has Paul Harrington; the Vermont hospitals have Mike Del Trecco; and there are a handful of others, like Nolan Langweil at the Joint Fiscal office and Robin Lunge, newly appointed to the GMCB after five years as a key player on Shumlin’s team.
Sterling can play on the same field as these experts.
Okay, but what difference is that likely to make?
Well, it could make a ton of difference because of the way Ashe is moving. To date, the Vermont Legislature has been at best a marginal player in health care reform. A very comprehensive bipartisan majority voted for the main health care reform bill in 2011, but its contributions have been minimal since then.
Most legislators, even the ones with direct responsibility for health care, really don’t have a serious grip on the issue. That certainly applies to Ashe. I have written about that issue before, and I’ll do it again in more detail in the future. The essence of that judgment is Ashe’s expressed view that the secret to health care reform is to establish a system of independent physicians, as opposed to an integrated system where hospitals and physicians have to take financial risk.
No serious player believes that, and I doubt that Sterling would risk his sterling reputation by propounding it.
Why is Ashe’s view so important?
The reason is that Ashe is clearly moving to take command of the whole Democratic policy apparatus. The Sterling appointment is the best evidence for that, especially in health care. Beyond that is the fact that the field ahead of him is wide open to an unusual degree.
Consider: There will be a new Speaker of the House. Mitzi Johnson is a widely respected chairman of House Appropriations, but she has no policy chops on other issues, and certainly none on health care. Her early remarks to the press after her successful Speakership campaign have been mostly about process. I interviewed her about health care last year and she, very straightforwardly acknowledged that she didn’t know much about it. “The policy people have to worry about that,” she said when my questions began to get into detail.
People who know her say Johnson is very smart, but she will have a tough time coping with Ashe in the normal House-Senate mud wrestling over issues. Ashe would have had a much harder time with the highly skilled Shap Smith as Speaker; and don’t even ask about former speaker Ralph Wright, who would have wiped the floor with Ashe.
Meanwhile, Rep. Bill Lippert, the chair of the House health care committee, who made his bones in the House as chairman of Judiciary, has struggled for two years to get a clear view of the health reform hairball, without much success. There are some potentially strong players on the House committee—Shap Smith called Rep. Tim Briglin his “rookie of the year” when he named him to Lippert’s committee—but that committee won’t have Sterling sitting next door.
There’s more: Ashe has a very strong base in the Senate. He could continue to serve as chairman of Senate Finance, which would leave him astride not just health care, but any issue that needs money. And he has some critical personal support from Democratic Senators Jane Kitchell, chair of Senate Appropriations, and Dick Mazza, who functions as a sort of benign godfather in the upper chamber.
A final note: While the political heat has barely cooled from the 2016 election, the fact is that politics never sleeps. So, it’s worth noting that if Ashe plays his cards well in the Senate he could become a dominating force in the Democratic Party statewide.
Sue Minter got soundly beaten by Scott in the November election, and she has no obvious platform going forward. Dave Zuckerman will be a Democratic Lieutenant Governor, but it’s hard for a lite gov to maintain an issue profile when all you do is preside over the Senate. The Attorney General-elect, T.J. Donovan, will almost certainly have a bright political future, but he won’t have anywhere near the policy and legislative exposure that Ashe will. ..
It seems obvious from all of this that Ashe is making a determined move, but it’s fruitless at this point to speculate on its impact on either health care or statewide politics. His fortunes in the political arena are a complete wild card: no one has any idea of how well Scott will perform; nor is it possible to say much about other Democratic players. And it won’t be possible for quite some time.
We won’t have to wait long, however, to assess his effect on health policy. If he stays on his independent physician track, that fact will soon be obvious and so will the inference that he is an opponent of serious health care reform. If he shifts course then he has a chance to become a very important player on the wide range of difficult decisions that lie ahead on the reshaping of the health care delivery system.