(Note: This is the promised update of my brief post from earlier today.)

You know that health care bill? The one supposedly “killed” by the House Health Care Committee on Friday on a 5-5 vote?

Well, IT’S ALLLLIIIIIIIIVE!!!

(Always wanted to say that.)

The panel approved it this morning, unchanged from its Friday form, on a pair of 7-4 votes. (Procedural thing.) The bill includes the penny-per-ounce tax on sugar-sweetened beverages.

There was some last-minute wrangling. Progressive Chris Pearson tried once again to add $800,000 more in premium subsidies for the working poor. This time, he suggested trimming the bill’s increase in Medicaid reimbursement to doctors and hospitals from the proposed 3% to 2.9%. But the Democratic majority balked; some feared that trimming the Medicaid reimbursement, even by a mere tenth of a percent, would jeopardize the health-care industry’s support for the Governor’s reform plan.

Two Democrats joined Pearson and Independent Paul Poirier in voting “yes.” One of them, Dr. George Till, asserted that the Medicaid trim might actually be a good deal for doctors and hospitals. If higher costs force more people to go without insurance under the exchange, he argued, then health care providers get stuck with more charity and Medicaid cases. And, he added: “In the exchange, the hospitals and doctors [will be] paid commercial rates, way above the Medicaid rates.”  

After the jump: a non-emergency, and a lot of intransigence.)

Pearson defended his pursuit of additional subsidy funds, not only as a matter of compassion but also as a way to help ensure the success of health care reform:

I would say that the strength of the health care system as we try to transition to [single payer in] 2017 depends on achieving our targets for the rates of uninsured. And I’m not at all convinced that this gets us there.  

Speaking of Till, remember how Friday’s vote ended in a tie because of Till’s sudden departure? Turns out he wasn’t responding to a medical emergency as reported; he left the room with the intent of postponing the committee’s final vote:

There was no medical emergency. It was not unreasonable for people to assume it was an emergency, because it has happened multiple times over the years here. But on Friday I was hoping for a little more time to get one side or the other to make a little movement. Because I thought people were being stubborn to the point of not being rational.

… I was hoping that over the weekend, we could get some movement from somebody, one way or the other, and I failed.

Till also asserted that “We have an absolute roadblock to adding $800,000 to that from the leadership.”

In any case, after Pearson’s amendment was disposed of, the committee again took up the Friday version of the bill, including the sugar tax. Poirier insisted on two separate votes: one on the state subsidy funding, and one on the remainder of the bill. His purpose was to get everyone on the record as supporting or opposing better subsidies.

Before the first vote began, House Minority Leader Don Turner entered the room and urgently requested a “two-minute caucus” with the three Republicans on the committee. (VPR’s Bob Kinzel pointed his microphone in Turner’s direction hoping to get some insight into the urgency, but Turner stayed mum.) Chairman Mike Fisher assented, and the Republicans left the room.

When they got back, the first vote was taken — on the subsidy sections of the bill. It passed 7-4, with two Republicans, surprisingly, voting “yes.” Pearson, Poirier, Till, and one Republican voted “no.”

The rest of the bill was then moved, and passed on a slightly different 7-4 vote. This time, all three Republicans plus Poirier were the “no” votes; Pearson swallowed his objections and voted with the Democratic majority.

After the votes, Till stated his ardent support for the sugar tax, displaying a chart that projects skyrocketing costs for treatment of obesity-related illnesses in the next five years. (Photo: Till explains his position to Peter Hirschfeld of the Vermont Press Bureau.)

If we don’t control the rate of spending on obesity, it’s going to swallow our budget. So to me, the sugar-sweetened beverage tax is an important part of that, because of the unique contributions that sugar-sweetened beverages make to obesity.

It’s fine if you want to drink them, but you ought to be willing to pay that. It’s the same thing as cigarettes. If you want to smoke, you ought to be willing to foot the cost of that. The whole cost of it.  

The committee’s vote was a victory for the alliance of health advocacy groups who have promoted the sugar tax. But it faces an uphill battle — first in the Ways and Means Committee, then in the full House and the Senate, and ultimately Governor Shumlin — who today reiterated his objections to the sugar tax idea. Long odds, indeed.