 Here we are. So James, I'm going to turn to you to rights and democracy asked to have some testimony on health, you know, range of health care issues, saying that some people might want to come and tell their stories. Others might want to comment on particular initiatives or legislation. And so that's what I'm anticipating. Is there more that you would like to say as a way of introduction James and then I think we Alex and Lawrence were prepared to be heard. And so, maybe we've turned to them and and then turn to Peter after. Yeah, thank you so much. Chair Lippert and the members of the House health care committee. I do have some testimony that is from our organization that that will be able to present and then turn it over to Angela and Alex and Peter. And, you know, as I said previously. Thank you, you know for for welcome was today my name's James Haslam the executive director of rights and democracy. I actually usually don't provide this role for our organization but today is our first ever lobby day. And it has really spread thin through many committees, talking about current legislation and this new coalition called Vermont renews. And everyone knows I'm really passionate about health care so I was asked to do this and joining me are Angela Lawrence Alex Laning and Peter sterling will speak afterwards. But before I began we wanted to share a land acknowledgement with the committee rights and democracy acknowledges the Mahakan in southern Vermont in the abanaki people as the traditional land caretakers of the end. Which includes parts of Vermont, New Hampshire, New England and Quebec. As guests of this unseated territory of the Mahakan and abanaki people we honor their ancestors elders and relations past present and emerging. We also acknowledge that our nation has benefited from the uncompensated and exploited labor represented in the legacy of slavery and the present day reality of migrant farm workers. And we also recognize that we have a new rights and democracy, which we often call rad for short, and our sibling organization the rights and democracy Institute. We're both founded in 2015 on the theory of change that a sustained collective action of people powered organization year after year can help make big, bold, long term changes in this country to advance human rights and build a real democracy. The theory of change is that it takes political infrastructure in this case a membership organization to sustain the momentum necessary to do that throughout in between elections. Rad members and staff work on issues and matters to our communities that matter to our communities, organize for policy change at the state and national level and recruit and train people to run for office. Our members are from all walks of life intergenerational multicultural activists artists organizers, but most importantly they're passionate fighters for true social justice and meaningful change in our communities and across the state. We have chapters across Vermont and New Hampshire, and you can look for us for wherever you are. We know our current systems are deeply dysfunctional rooted in historic oppressions and fragile. When those fragile systems break it is Vermonters who have been systemically kept out of places of power that are the most impacted. We have an acting indigenous persons racial and ethnic minorities, LGBTQIA individuals individuals with disabilities senior citizens new Americans migrant community youth young adults poor working poor are the ones who carry the weight of policies and systems gone wrong. We are nearly 80% of Vermont voting voting population, the least represented in our state government, and are in some cases wholly invisible to those who enact the policies that can provide deadly, they can prove deadly to their communities. We recognize that there are powerful forces that strategically use racism and hate to divide our communities but we know that when we come together we can build a strong multi racial democracy in which everyone can thrive. It's a pleasure to testify you today and to share our visions for collective liberation in a more just and vibrant Vermont. On a federal level we are working hard to promote the thrive agenda, the next generation of comprehensive reformed reform date birth in the transformative work of the Green New Deal. The Green New Democracy Institute has joined hundreds of organizations across New England who are joining forces to bring a shared agenda that amplifies the power and will of the people and have form and have formed the renew New England Alliance to push forward bold structural change across all six states. Today we are thrilled to roll out our Vermont's call to action Vermont renews. Vermont renews is a new and growing coalition of leading grassroots organizations, labor unions, racial justice groups frontline communities and environmental advocates. We've come together to address our state's overlapping crises of unemployment mass unemployment racial injustice the coronavirus pandemic and climate change globally a haunting truth must be reckoned with and addressed people on the global majority BIPOC and our poor bear the largest negative impacts of the environmental crisis and are the least contributors to the crisis itself. We believe strongly that any solutions proposed should be designed and help heal and restore our communities as an intentional priority rather than a hopeful aspiration on a trickle down approach. Right to democracy Institute is addressing this head on through a formation of a BIPOC centered advisory group of experts to guide this process and policy proposals that help us reach our climate goals. This Council recently submitted a letter to the state of Vermont and raise to raise the hope streams demands of those most impacted as the guidance for the work ahead. That letter has been shared with this committee, and I encourage you to review and hold words in that letter to your heart as you make your policy recommendations and decisions. Currently our coalition is working diligently to on innovative policy proposals and areas of housing justice food justice and green justice zones and emerging initiative that uses data mapping community design and participatory budgeting process to support community utilization. And of course we are ever present for the conversations relating to social justice issues. It is important that we lift voices of people today. And I'm been excited to be joined by some of our partners and amazing members today in this committee and throughout the legislature today. Two dozen individuals are speaking their truths and committees throughout the legislature, and I ask you to hear their stories on their courage and testifying their support that they went the time shared today. We're also asking, we're asked to speak specifically on a piece of current healthcare legislation, the joint legislative healthcare affordability commission in the budget bill age for three nine. The health rights and democracies and organization that it strongly believes in the right to healthcare to all people and believe fundamentally we must shift from treating healthcare as a commodity to as a public good. Given that we support any and all efforts to expand public health care programs as the current private health insurance marketplace is a major problem for far too many families. So we see the problem at as being a partly a financial one. A 2015 Harvard University study found that 62% of personal bankruptcy filings are due to medical bills. Other research has produced similar findings. Most from honors and their players would agree that the cost of health care is too high and the causes. Great financial hardship. In September of 2020 a poll commissioned by the Alliance for a better Vermont founder said that the are they are most concerned about the cost and availability of healthcare. 69% were very concerned over issues such as the economic impacts of coven 19. We still have a support for small businesses and the local economy and jobs and unemployment. We still have too many people uninsured and have a growing crisis of people under insured who simply can't afford the out of pocket costs that are expected to pay when they need care and medication. So this is why we think we need to act now. We have a health care reform friendly leadership in the US Congress and public opinion remains strongly behind the Biden administration pursuing big reforms funded by the federal government. Vermont needs to start preparing now to take advantage of this window of opportunity because Vermont needs federal financial support to enact any meaningful health care reforms. We believe it is also time for the states to signal that they're prepared to work with the federal government. We must begin immediately to begin legislative support for any sweeping changes to our health care system, including any significant expansion of our public health care programs. So this is why we think this commission is a good idea contained in both language in the preparation for a six member joint House Senate commission to hold public hearings in the fall of 2021 and study various options to expand public health care programs and other things move for monitors at a high cost private insurance plans into more affordable public option type coverage. The commission would directly engage for monitors who are most adversely impacted by lack of equitable access to health care through a series of community meetings. This is the kind of participatory democratic community based research that we believe is essential to development of public policy that meets the needs of our diverse communities. If we were to offer any recommendations to this committee would be to ensure that every adversely impacted can constituency can be represented, which sometimes might require removal of and all the barriers to community participation such as interpretation transportation and childcare. The commission has in its mission to explore ways to work with the Biden administration on these reforms, given that the Biden administration as well as Senator Bernie Sanders have both publicly supported an age bandit approach to expanding access to public health care programs, as opposed to solely relying on a single pair approach. The commission has charged the commission to specifically explore options around expanding access to Medicaid to allow enrollment for the 50 to 64 year old age age band potentially helping out about 110,000 people to be able to get more affordable access. The commission would hire experts do its research and hold eight public hearings and come back in the legislature in January 2022 with recommendations. This healthcare affordability commission included is the appropriate vehicle to jumpstart a necessary very necessary public conversation on what for monitors and their employers are paying for health care. To support their goal to consider practical and short term pathways to expand asset access to health public health care programs. For example, bringing more youth and those over 50 for into these public programs, while also more broadly reviewing Vermont's current approach to managing health care affordability. Our communities need both immediate options for reform and the opportunity to participate in community led reflection on our need for more systemic reforms. Who else is supporting this other organizations supporting this are conclude the Vermont in the AARP Vermont v perk United Professions of Vermont American Federations of Teachers, Planned Parenthood of Northern New England, and Vermont Interfaith Action, who collectively represent 10s of 1000s of Vermonters. So thank you so much for hearing all of that and also for your service for Vermont with that I'll turn it over to Angela and Alex and Peter. Okay, thank you, James. I welcome you to. In turn, share your stories or your thoughts with our committee. Oh, I'm happy to go if folks want. I think I think I think Peter we were actually going to hear from Alex and Angela first. Good morning, everyone. I'm Alex Lenning. I'm a resident of St. Alvin city executive director of a mental health nonprofit and adjunct faculty member and a suicide prevention education and hospice volunteer. Thank you again for the opportunity to speak with you today and for rights and democracy Vermont for the invitation to share my thoughts. I'm sharing my testimony as a citizen and advocate, call to action for increased diversity, equity, accessibility and inclusion across Vermont's health and mental health system of care. Your support for age 210 and the establishment of a health equity advisory commission has provided a vital opportunity for transparency around the data and stories which validate what we know to be true. Racism is a public health emergency. What we do is it a human rights issue. We know that our BIPOC communities have experienced disparities and outcomes related to COVID-19, as well as mental health. This is also occurring in our LGBTQ TIA to plus in other communities, which have experienced marginalization and barriers around access to critical care and information. The BIPOC has forced us to reassess and reassert community needs. Unfortunately, the evidence demonstrates that systemic inequality and discrimination means that many Vermonters remain underserved. The Vermont Department of Health recently shared data which documented this impact. And I was particularly moved by a line from a report by the National Academy of Sciences, Engineering and Medicine, which concluded quote, we have a pandemic that is dramatically influencing minority and underserved communities to a much greater degree than the general population. And that means those individuals and those communities are essentially double at risk for what they're referring to as mental health challenges. They are more likely to have been impacted and they have existing risk factors that raise the risk of mental health consequences and quote. With this overall context and knowledge of those risks apparent before us, one community that I would like to share my perspective on today and my role as an educator, which has been especially affected by the pandemic are BIPOC college students. They have endured unique and compounded challenges facing unparalleled issues related to housing, learning and healthcare simultaneously. I'm here specifically to ask for your support of increased peer mental health services within our higher education system, a current gap and essential need. A 2020 NIH study found that 71% of students surveyed indicated increased mental health challenges as a result of the COVID-19 pandemic. They indicated that 91% reported negative impacts because of the outbreak. 89% identified difficulty in concentrating and disruption to sleep patterns. Public health measures such as social distancing also played a role. 86% reported decreased social interactions and 82% expressed concerns about academic performance. Overall reactions to these significant struggles were mixed with students adopting both positive and negative coping mechanisms to address those issues. According to the most recent national peer education survey, approximately 40% of students turned first to peer educators or counselors for support with their mental health concerns, or to address suicide prevention topics. That is to say, the first and perhaps most meaningful conversation that many students may have about their own struggles is with another student. As someone with their own lived experience of depression and anxiety, I know that the first conversation which perhaps saved my own life was not with my family, not with my doctor, not with a faculty member, it was with a friend. For over a year, our shared vision for a resilient Vermont has been stronger together. For recovery and survivor communities, it is clear that frontline peer support is effective, meaningful, and vital to mental health, well-being, and self-care. I urge you to consider additional funding, study, and legislative action to ensure that this remains a priority as life with COVID-19 begins to shift yet again, and we are asked to pivot yet again. For support, I would like to also offer my perspectives on the power and potential impact of online mental health services, for virtual mental health services. In my professional role, I am involved in workforce development and training for both new and established providers. Over and over, I hear that there are simply not enough counselors, social workers, and therapists to meet the needs of Vermonters, especially BIPOC Vermonters. The solution I would ask this committee to explore is expanding the capacity of telehealth services through an interstate licensing compact or similar arrangement. This will allow fully qualified practitioners who live outside of Vermont to provide critical care and support for our residents. It could also foster workforce recruitment and help advocate for expanded access to care by highlighting the important role of broadband infrastructure improvements. The ability, affordability, and insurance status should not privilege healing, especially during a global pandemic. In our shared grief, in our acknowledgement of and commitment to dismantling systemic racism, and in recognition of the needs of our patients, clients, and peers, I asked the legislature to continue to address healthcare inequity, and to address services for improving positive healthcare outcomes for our communities, especially BIPOC communities. I'm grateful for your time and attention today. Thank you. Thank you, Alex. And thank you for your sharing your thoughts as well as your personal experience as well. Perhaps turn to Angela, are you. We're prepared to hear from you Angela, if you wish to share. Hello, good morning, everybody. And the part in the health healthcare committee. My name is Angela Lawrence. I am currently live in Bretterboro. I'm a mom. We are a military family. Also a member of the rights democracy. And I'm a first American generation and a first of a minor generation as well. My personal issue today is healthcare. We need healthcare. It's a crisis. We all know it's a crisis in our state, in our country, specifically talking to people around my age. I have been put in a spectrum of disability, having disability and having mental health. And being a mom of two boys, being a young 31 year old woman of the BIPOC community, you would think I'll be young, energized, workaholic, love to play, love to run, do all these things in my little two boys. But I've come to tell you that I cannot do that. The reason why I cannot do that is one, I have a disability. Rheumatoid arthritis. I don't know if we, I know we have some doctors and nurses here. I hope they can rectify this information. Rheumatoid arthritis is a chronic inflammatory disorder affecting many joints, including those in hands and feet. This immune system attacks its own tissue, including joints. In severe cases, it attacks internal organs. Rheumatoid arthritis has more than 200,000 cases in the US per year. The information has this affects over long periods of time, information associated with our recalls, bone erosion and deformity. I have another one, fibromyalgia. It's a widespread muscle pain and tenderness. It affects about 3 million people per year in the US. As you don't know as well, my official pain syndrome. It's a chronic muscular pain disorder. It's a disorder in which pressure on sensitive joints in the muscles causes pain in similarly unrelated body parts. It also affects 200,000 people per year in the United States. I cannot have or get medication because of the insurance policies and the insurance, the whole insurance spectrum. I believe I'm in the low level of the Vermont Health Insurance. I believe it's called the Green Marine Care. And me and my team and my doctors have been trying for years and years to be able to get approved for a medication that is willing to help me be able to do the activities, daily activities that you guys do on a daily basis. Like picking up my own 20 month old, how hard it is and pay for it is just to pick them up from the floor to my to my hand. Another reason I can't even run. I can't run like I used to miles and miles and miles. I can't do that. My top, I can only walk for 10 minutes. I cannot long cannot walk longer than 10 minutes. If I do, I am swollen. I mean pain. I'm just at all. The medications that they've tried, we've tried, I've tried two medications. One called Symsia. Another one called Humera. Currently, I'm in one called Embrol. The medications are given to people who are breastfeeding as I am currently breastfeeding my 20 month old. There's all the only three medications are given to women who are breastfeeding while having this disability. One of my issues with this medications, the Humera, I was on my, the Humera for a while, it did not work. I'm on Embrol. It has progressed my disease drastically. The only one that I tried that did work was Symsia. But because I'm under Vermont insurance called Green Mountain Care, which is a loss. Vermont insurance has denied me numerous and numerous times to get this medication that would work and for me to be able to do what I need to do for my kids and for my family. This medication has been denied with the doctors been fighting and fighting and fighting to this day to try and get this medicine approved and cannot get approved. Why? Because of money. Money is the reason. Why do we have to choose between saving somebody's life and be able to have a healthy living style than having money? You know, it shouldn't be like that. You should be, we should be focusing on people's health, their concerns, their issues. Today I have a meeting with my pain management team. I'm meeting them for the first time because I was diagnosed with fibromyalgia recently. I practice at least every two weeks because of my back. My back is almost like they said of a 60-year-old old woman. Mind you, I am 31 and have a back of a 60-year-old woman. To me, that feels really disgraceful for me because I'm supposed to be a 31-year-old healthy human being and be able to do daily activities with my family. But I cannot do that because the insurance is telling me because the amount of medication is so expensive they're not willing to help me be a better person by being able to accept the medication. So I'm fighting and fighting for my life. I'm in pain every day, 24-7. I sleep less than six hours a night because of this pain. I have mental health. The mental health does not help at all. Having anxiety, having depression, having PTSD and all that stuff. It doesn't help because you can get, first of all, can get the doctors or the counselors you need because either out of the network or the insurance doesn't cover them. So you can get the help that you need. On top of it, I have four impacted teeth. It has taken me almost four years to try and find an oral surgeon or not alone even a dental office to see me because I'm under a state insurance. They do not take people under state insurance, especially green mountain care. And for me to be turned down for health needs because I'm on a state insurance and my family works a butt off to be able to be where we are. The reason why we ended up in a state insurance because we were laid off due to the pandemic, but because that's still going on, my husband had to be self employed and was still under state insurance. I couldn't find a dentist for my own son. My son was one at the time, took me at least almost another year and a half to get him into a dentist. The closest one that was available that was taking state insurance was in Bennington. If you guys know it's a now a drive from Brattleboro to Bennington. So I'm driving far away to get the care I need rather than getting the care I need here close to home. Tons of dental offices, we have done tons of oral surgeons, but we still been pushed back to go far away to get any health care needs, because all these people are taking away the part where people are in state insurance can get health care needs in local communities. I had to wait for two years to finally just got that month to call me for oral surgery. I have four impacted teeth I have had for almost over 10 years, and everybody keeps turning me down, they came pay for it because this insurance I'm on is on a spectrum. A low spectrum. This is a disgrace. Me being sick the way I am. I need help. I need health care. I need, I don't want to be put in a spectrum a low spectrum where I cannot get doctors. I cannot get counselors. I cannot get the medicine I need because it's cost effective. I cannot. It's baffling. It's, it's, it's, it's to me, I'm tired. I'm tired to keep fighting for this needs. I'm tired to try and get help that I need. And it's gotten to the point where I have to see counselors all the time I have to see my therapy all the time, because I'm so worried where my health is going to be in the next, not two years, not three in the next six months. I'm worried that my health is progressing. But because the lack of having the insurance company giving me the best medication to help me. I cannot do that. I worried about how I'm going to be able to able to play with my kids when they're 10 when they're 12. That's when they're really active, very active kids, and I cannot do that. So think of, think when you think of doing all this healthcare bills, think about the future. Think about our kids. The rheumatoid arthritis also affects kids younger than 16. So I worry about my kid, my kids getting this and not getting the support they need from the healthcare system. It affects 50,000 kids younger than 16 in the US. So imagine those kids can be any of your kids, grandkids, great grandkids. We got to look out for them. You're not going to look out for me, at least look out for them. Please, please understand that we need a healthcare bill we need not to be put in a spectrum. We need to be acknowledged as one person. We are all human being. We're all one people will own one person. Let's acknowledge that first while all human being first. So let's take care of our health and let's take care of your future. Thank you for hearing that me today. I appreciate it. Thank you. Thank you, Angela. I deeply appreciate your willingness to come forward in this setting and share your personal life and your family's struggles. I can only say that it's important for us to hear you and to hear your family's struggles and stories as we try to make the changes that are going to result in healthcare being available for you as well as others. And I know that it takes a certain kind of courage or certain kind of willingness to put yourself out there, particularly when we can't even say hello face to face. I'm so sorry we're not able to do that, but I do want to say how much I appreciate your talking with us today. Thank you. And I would just say this before we hear from Peter as well that when you say think think as you're working on healthcare. I think as I work on healthcare, I will think of you and others. And that's what we need to do. We need to it needs to be personal. It needs to be real. And you help help make that very real and very personal. Thank you, Angela. Thank you. So I am going to turn to Peter. I think we have time still to hear from you, Peter. Okay. And, you know, I don't want to stand between legislators and their much needed break before you go to the floor and whatnot so I will move right along. My name is Peter Sterling and for about 10 years I worked on various healthcare reform efforts, including running a navigator organization and doing outreach and enrollment work where I got to hear from hundreds of reminders about their issues and enrolling, trying to get affordable healthcare. I'm here to say that after four long years of the Trump administration's opposition to expanding access to public healthcare programs with the election of President Biden. How is the time to reinvigorate and restart the important for mock conversation about expanding access to our public healthcare programs like Medicaid in order to lower people's premiums deductibles and other out of pocket costs and truly make healthcare more affordable for these costs to remodels and their employers are very, very real. Right now if you're in the healthcare exchange and you're not eligible for any subsidies and you're in a family of four, making about $105,000 that's the limit, you're out of pocket costs are capped at over $28,000 that's about 26% of your pre tax income. That would potentially go to your, your cost sharing your co pays and your out of pocket max and your prescription drug out of pocket max. And these expenses aren't necessarily any lower if you're receiving other employee employer sponsored insurance certainly it's been in the news that teachers health care has been increasing and state employees health care is cost costly to. The problem is there seemingly no end in sight to these increases over the last four years blue cross blue cross blue shield of Vermont has been granted general rate increases of 7.3% 9.2% 5.8% and 12.4% which needless to say is far larger than the rate that the state's economy or people's salaries are increasing. So, one of the ideas that's coming out of the by the administration is an eight bit age banded approach to expanding Medicare, or letting states do that for Medicaid I think James has mentioned the idea of expanding Medicaid in Vermont to the 50 to 64 year old crowd that would help about 10013,000 people move from high deductible or high out of pocket cost private insurance into a public plan. So, while the Kaiser Family Foundation has recently issued a study on what the impact of expanding Medicare would be which of course the states can't do that's a federal program we can do Medicaid but I think the comparable. The information is comparable to the impact you could have in Vermont so Kaiser Family Foundation found that lowering the age of Medicare eligibility down to 60 from 65 could reduce costs for employer health plans by up to 15%. If you were to lower the age of Medicare eligibility to everyone 50 and over that would reduce costs for employer plans by up to 43%. So there's potential real savings for employers there. And I think the necessary first step for the legislature to best understand its options for moving forward. If you're ready Vermont to take advantage of any opportunities created by the Biden administration is contained in the budget language, coming back to you from the Senate. There's language in the budget, take it from S 120 to create a new joint legislative healthcare affordable study committee, which would then be charged with doing public hearings and making recommendations to the 2022 legislature about various options for access to affordable health care programs like Medicaid. I'd like to wrap up by saying to ask you to please support the creation this commission so we can jumpstart our conversation about how we can reduce the burden of health care costs for import Vermont employers and how to move more Vermonters out of high cost private insurance plans and into much more affordable public health care programs. Many many thanks for sharing for allowing me to share my thoughts with you today. Thank you. Thank you, Peter. And I want to just, and I want to just acknowledge that we we will be review we are in the process of reviewing the budget language we had actually planned to review the language you're referencing. I don't want to compare to your testimony but because our questions and testimony ran longer we're going to we're going to return to that in the next several days. But we will be taking taking a look at that and in conjunction with our House Appropriations Committee of course. So thank you. It's been a few minutes and I see representative Goldman has her hand up is that so let's this is I'm going to take a few committee questions and then and then we are going to wrap up because we've gone a long time and we also have frankly need to make sure that everyone gets a break before we turn our attention right back to the floor. So represent Goldman. Thank you so much all for coming I think you know from going to the personal to the policy level really you know sort of defines it very well. I went to your website and looked at your health care justice, you know statements which are really great. I'm wondering if a small state like Vermont can really solve the problem on its own. I know that you're creating this coalition with other states and I was just wondering if you've had any thoughts about how we could work together maybe regionally to think about health care solutions. Thank you very much representative Goldman. I think absolutely we are we're we think that you know we should explore every every way we can to expand the access to health care and expand public programs and think that you know that that could be something down the road. We do think that you know that there is a role for for Vermont to play to continue to demonstrate. We can move forward, but you know absolutely see that as partly, you know, dominoes to actually turn this country around because ultimately, you know obviously a lot of the programs that we've discussed in Vermont that we discussed here today are best as programs, but the way to get there, you know, we believe is is starting with state action and moving from there but we are working you know in, as you said, you know in New Hampshire and across the region and are certainly open to helping, you know be part of a conversation about what regional systems could look like. But yeah, we do think the is Peter Stirling was just laying out and we spoke to this is a good start with this with this commission to really jumpstart this effort, and particularly because it's tied to a lot of the conversations that are happening now at a federal level that our senators and congressional delegation are part of. So it is not happening in isolation of others might have other set things to add to. Thank you. Other comments from those who refer to him today. Well, I would just jump in representative that when I was in the pro temps office I actually tried researching whether we could form a regional exchange. You know, Vermont has a very small pool we don't have that many people and our exchange at some level suffers from high rates because of the small pool. I looked into whether we can form a regional pool with Massachusetts, New Hampshire and Maine for our exchange and it never really took off. But the thing I would like to add is, we can only really move forward on any kind of healthcare form of flavor willing federal partner who's willing to allow us to get a verse necessary to use existing federal funding to fund other reforms and the bigger piece I would like to say is, is what we would do with any kind of Medicaid expansion is probably reduce premiums for some people and then shifted over to the public sphere so I like to think it was more as moving money around not creating new, new expenses for people so I think a small state like Vermont can do Medicaid expansions loan we did it for Dr dinosaur we did it for v half we did it for cat amount. I think we can do it again. Thank you represent Peterson. Yes. Thank you. Angela, I was thinking while you were giving your testimony. Have you been in touch with the Vermont health advocates. We have a health agency that you might want to contact and pose your problems to them. They may be of great help. I don't know if you've reached out to them. I'm Peterson I have not reached out to them. The only people I've been discussing with my doctors and they're teaming up with their own team. And that's how we've been trying to fight the medication issue is that but I will surely look that up and I'll try to do that. I would suggest that they they advocate for people. I think like you who have problems. The healthcare advocate and we can make sure that you have access to that information. I'm sure James has that information as well. Because they, they do, they advocate, not at the policy, well they have some of the policy that but they, they, there's their limits to what they can do but they they've been very successful in helping individuals as well. So, I hope you hope you do reach out to them. Thank you. For some of us it's it's been a long period of time, not having a partner at the federal level. In fact, having an adversarial relationship at the federal level around healthcare. Let's put it out there. And this committee has tried in that interim period to defend Vermont's healthcare progress. And I don't, I won't try to review what we've done but that. It's a different era, and we need to, we need to find ways to take advantage of opportunities that are presenting themselves, some of which will be, which are already underway. But I will take to heart and I do take to heart both the personal testimony here today as well as the advocacy for trying to find ways for for us it as the state of Vermont. We will use the openings provided by the Biden administration to make some additional systemic change on behalf of Vermont, Vermonters and healthcare. We'll look at the language and we'll, I mean, we may make some suggestions to that language to modify that language but we're, at least I as a chair, I'm open to understanding what the proposal is coming from the Senate. And we will, we will, we have time to do that still. And we will do that. I think at this point, I want to say thank you again to each of you. Apologies for the, I mean, at least we got to say hello to each other and introduce ourselves in that awkward early period without YouTube but thank you for being flexible and making time to take out of your lunch hour as well. I realize this is not just our lunch hour it's your lunch hour. So, thank you, Angela. Thank you, Alex. And James and Peter. I look forward to us staying connected and staying in touch as we continue what is going to what is indeed a journey. Unfortunately, it's not just a sprint, but it's a journey to getting where some of us believe we really belong which is healthcare for all. As a human right. As I say, I, based on my legislative and lived experience, I'm committed to taking steps that move us there. Even though we can't always take the leap that we'd like to do. And I would just, I hope you're aware of and I think you are probably, you must be. But we've taken a small step but I think an important step that is was initiated by this committee and just that House bill 430 to extend healthcare to extend medical care to some of the Vermont folks who we live with and work with who do not get access to aid and Dr. Dinosaur because of their immigration status and we're pleased that we're able to at least take a small but important step there and have that take place in the next period of time. So we will let's continue to work together. Let's continue to think together and advocate together. So with that, I think I'm going to suggest that we bring this to a close for what is now the afternoon and no longer the morning. So with that in mind, thank you for having us. Thank you, Alex, Angela, and Peter. Take care.