This year, the House panel has been considering the first in what's expected to be a series of bills to implement that broad plan.
One provision in this year's bill that drew criticism from several of those testifying would outlaw so-called "bronze" insurance coverage plans, with high deductibles but which carry lower premium costs.
Craig Fuller of the Employers Health Alliance presented the committees with a chart showing a Blue Cross-Blue Shield of Vermont family coverage plan with a $5,000 deductible — an amount to be paid by the family before coverage kicks in — cost about $13,169 per year. A plan with lower deductibles costs $19,739 per year, he said.
Sara Byers, executive vice president of the Leonardo's Pizza chain, said the majority of businesses in her area's Chamber of Commerce used the bronze plans "because that's all they can afford."
Another question lawmakers have been grappling with is where to set the size boundary for businesses that need to be in the health care exchange. Some argue it should be those with 100 employees or fewer, saying a larger pool of people sharing risks should lower costs. Others argue it should be 50 or fewer because larger businesses are making progress already keeping down health care costs with wellness programs and, through the high-deductible plans, greater cost-sharing with employees.
Larger businesses should be able to decide whether to join the exchange, Byers said. "Businesses should be able to decide where to allocate their health-care dollars," Byers said. "If the exchange is better, businesses will use it."
Peter Sterling of the Vermont Campaign for Health Care Security did not testify but offered a competing view in a corridor outside the hearing room. He said employers might like health plans with high deductibles, but employees can't afford to pay $5,000 out of pocket.
Some of those testifying urged lawmakers to forge ahead and push the state as close as possible to a Canadian-style, single-payer health system.
"I want them to go away form the exchange and go toward single-payer," Russ Bennett, president of NorthLand Visual Design and Construction of Waitsfield, which designs large props for concerts and festivals, among other projects, said after his testimony. "We need to limit as much as possible insurance being in the middle."
Others voiced criticism that lawmakers and the administration of Gov. Peter Shumlin had not yet decided how the new system would be financed, or specified what health services it would cover.
"I'm not a car salesman, but I would like you to buy this car," said Doug Gage, a Rutland truck driver. "I'm not going to tell you what model, make or year it is. I'm not going to tell you how many miles or on it. I'm not going to tell you what condition it's in. ... But I want you to sign the bottom line. Would anyone in their right mind do that?"