Health care costs have soared over the past several years and Vermonters are definitely feeling the impact. While education reform dominated the legislative session, health care reform had a lower profile, but some progress was made in limiting the price of life-saving medications, reining in hospital costs, improving financial oversight of the state’s largest health care organization (UVM Medical Center), and supporting reproductive health care.
However, any progress may be undone by the brutal cuts to the Medicaid health insurance program and Supplemental Nutrition Assistance Program (SNAP) in the federal bill championed by President Trump and passed last week by the Republican Congress. These programs serve thousands of Vermonters, many of them children and senior citizens, keeping them healthy and fed through an incredibly effective state-federal partnership. An estimated 45,000 Vermonters will lose their health insurance as a result of Trump’s bill that will also blast holes in Vermont’s state budget while providing tax cuts to wealthy individuals and large corporations. The Medicaid cuts are expected to be especially harmful to rural hospitals, slamming the hospitals that serve Vermonters and under-cutting our efforts to reduce health care costs. Read this outline of what’s in the Trump-Republican bill, which describes the cuts to critical programs, including Medicaid, food assistance, green energy, and higher education, and tax breaks largely for wealthy Americans.
Reference-Based Pricing (S.126/Act 68) – By FY27, Act 68 requires the Green Mountain Care Board to implement reference-based prices for hospital services, limiting the amount a hospital can charge for a service. These prices would be set as a percentage of Medicare prices, with the goal of lowering health care costs for Vermonters. The bill also includes several provisions to ensure better oversight of hospital budgets such as implementing simplified global budgets, a requirement for a health care strategic plan, and incentive grants for hospitals to participate in reform efforts, Read this summary of Act 68 for more details.
Prescription Drug Pricing (H.266/Act 55) – In addition to hospital costs, prescription drug prices are a major cost driver for health care in Vermont. Act 55 makes oversight and administrative improvements to the 340B prescription drug program, a federal program which is a major source of lower-cost prescription drugs for many hospitals, to ensure better financial accountability for the program in Vermont. In addition, Act 55 prohibits hospitals from charging more than 120% of the average sales prices for each prescription drug administered by a hospital in an outpatient setting. Based on a recent report from the RAND Corporation, Vermont hospitals charge the highest rates in the country for these life-saving drugs. Read this summary of Act 55 and this article that outlines provisions in both Acts 55 and 68.
Oversight of UVM Medical Center (H.482/Act 49) – The University of Vermont Medical Center is one of the most expensive hospitals in the country. In recent years, the Green Mountain Care Board (GMCB), Vermont’s hospital regulator, has raised significant questions about UVMMC finances, but UVMMC has not always been forthcoming. In addition, UVMMC has exceeded the budget approved by the GMCB several times recently, putting financial pressure on both Vermonters accessing care at UVMMC and Blue Cross/Blue Shield, the state’s largest health insurer. In fact, BCBS is in financial crisis. Thus, Act 49 permits GMCB to reduce a health insurer’s reimbursement rates (i.e. prices for services) for one or more hospitals in the state if the health insurer is facing an “acute and immediate threat to its solvency.” In addition, Act 49 permits the appointment of a hospital observer to monitor the hospital’s operations, obtain information from the hospital, and report findings and recommendations to the GMCB. Former Agency of Human Services Secretary, Mike Smith, has been appointed to do this work.
Reproductive Health Care (S.28/Act 20 and S.18/Act 19 and S.53/Act 50) – With continued threats to abortion and gender affirming health care nationwide, I introduced S.28 to strengthen Vermont’s existing “shield law” and ensure that both types of care are well-protected in Vermont. The bill ensures that medication abortion care is available through telehealth, expands the scope of the Consumer Protection Act for untrue or misleading advertising in health care, and further protects relevant health care records from public disclosure. Read a summary of Act 20 here. Act 19 permits the licensing and operation of free-standing birth centers in Vermont, providing a lower-cost and safe alternative to hospital births for low-risk pregnancies. Act 50 creates a certification process for community-based perinatal doulas, health care providers who support women through childbirth. Together, Acts 19, 20, and 50 help ensure Vermont’s constitutional right to reproductive liberty by providing Vermonters with robust reproductive health care protections and services.
100th Anniversary of Porter Hospital (SCR 5/Act R-71) – This year marks the 100th anniversary of the opening of Porter Hospital. Named for William Henry Porter who donated funds to Middlebury College to build a hospital “for the use of the College and the people of Addison County,” Porter Hospital opened on June 15, 1925. To recognize the importance of Porter Medical Center to our community, I led the Addison Delegation in sponsoring a resolution that “marks 100 years of providing outstanding health care services in Addison County.” I read the resolution and presented an official copy to Medical Center leaders at the Porter Birthday Party last month. You can read the full resolution here.
Photo Note: Reading the Porter Medical Center resolution at the celebration on June 14, 2025
Ruth for Vermont 