Health Care Committee

The House Committee on Health Care considers matters relating to health care, defined as an integrated, holistic system of care that includes policy development with and oversight of the Vermont Departments of Health Access, of Mental Health, and of Health, and health equity, health insurance, health care delivery improvement, and other similar policies.

H.266/Act 55  (An act relating to the 340B prescription drug pricing program) of 2025 related to the 340B prescription drug program in which hospitals are limited to charging 120% of the average sales price (ASP) to insurers. This legislation had the immediate effect of reducing Blue Cross and Blue Shield (BCBS) premiums, and reducing health care premium costs for school-employee health insurance from the anticipated 12% increase to less than 7% increase (New Hampshire saw a 23% increase in premiums in the same time period). The bill was a major contributor to the overall cost savings to the health care system of approximately $230 million. 

There were millions of dollars in real savings to Education costs (not “buy down savings”) through health care legislation this budget year. The predictions in the 1 December 2025 letter that property taxes would increase by 12% was highly inaccurate, with many school budgets coming in at between 3% and 7%, in part due to health insurance savings and careful work by school boards. The end result is substantially lower tax increases, even before the one-time buy down. 

S.126/Act 68  (An act relating to health care payment and delivery system reform) of 2025 enacted reference-based pricing. This legislation requires the Green Mountain Care Board (GMCB) to establish reference-based prices that are the maximum amounts Vermont hospitals can accept as payment for certain services, including those delivered outside a hospital setting like primary care. The “reference” is tied to a known number connected to what Medicare charges for the service. For example, the reference might be to limit the cost of a service to 250% of the amount Medicare charges for the same service. All stakeholders - hospitals, the Department of Financial Regulation (DFR),  insurance companies such as Blue Cross and Blue Shield and MVP, and the GMCB - agree it is essential to implement reference-based pricing and that it will result in downward pressure on the costs to the Vermont Health Care System. This work is being done with due consideration to the financial needs of specific hospitals and to their delivery of essential services. Act 68 had an overly ambitious timeline of implementation by hospital fiscal year 2027. The GMCB is still in the rule making process and the metrics are still being designed.

Act 68 led to S.190 (An act relating to reference-based pricing and the Green Mountain Care Board), a bill that was intended to implement the beginning of reference-based pricing for the coming year by targeting the savings to important groups: individuals, families, and many nonprofits and small businesses on the Qualified Health Care Plan Exchange (QHPs) - the most expensive and vulnerable group, due to the increase in premiums from the elimination of federal subsidies; and school-employee health plans (to reduce education costs and property tax increases). The bill passed the House and Senate, but was vetoed by the Governor on 16 June 2026 Democrats are working to reduce the cost of health care, to save on property taxes, and to bring affordability to Vermonters. Evidently this is not a priority for the Governor.

S.189/Act 146 (An act relating to establishing a process for the elimination of certain hospital services) sets forth the procedures that must be used when a hospital wishes to close an essential service line. The legislation is needed because of several poorly-handled eliminations of hospital-related services (i.e., primary care in Waitsfield, psychiatric beds in Berlin, dialysis and the threat of pediatric bed closure in Rutland). The House committee created a list of essential services, and designed detailed steps that a hospital must take when it considers closing one. Those steps include a non-public early stage in which there is notice, information and discussion among the Health Care Advocate, the Green Mountain Care Board (GMCB), the AHS, and then adequate notice, public involvement, and GMCB review. Democrats have worked hard to keep essential services available in hospitals in all corners of the state and to ensure the public will have a process that allows for time to understand and weigh in on decisions by a hospital to close a service line. The bill passed the House and Senate, and was signed into law by the Governor on 16 June 2026.

H.583/Act 133 (An act relating to clinical decision making)  as drafted would have been the strongest legislation in the country to keep private equity out of the practice and delivery of medical care in Vermont. The Health Care Committee heard many stories of private equity buying medical practices or hospitals and decimating the quality of care, reducing and diminishing the number of and qualifications of practitioners, creating unsustainable work burdens, controlling medical and hiring decisions, forcing medical providers to pay a mortgage on their own building, and then selling or closing the practice or facility leaving folks without medical care. Private equity has infiltrated Vermont healthcare in two areas: nursing homes and substance abuse disorder clinics. The opposition to this legislation was formidable. The result is a watered-down bill that keeps clinical decision making entirely under the control of the health care providers. We hope to strengthen this in the future. Democrats strongly supported and have worked on behalf of efforts to create and maintain the quality of health care in Vermont, and to keep private, for-profit business entities out of the practice of medicine. The bill passed the House and Senate, and was signed into law by the Governor on 15 June 2026.

Universal Access to Primary Health Care:

With the enormous cost of health care, many Vermonters are asking for universal health care now and suggest that the best path forward is through universal access to primary health care. The House Health Care Committee hosted a public hearing in April 2026 and heard from many people on the importance of making sure every Vermonter has low-barrier access to primary health care. Every one dollar spent on primary care saves the system $13, allowing patients to see a physician before health issues become more serious (and more expensive to treat). The committee heard testimony on how this lack of access is failing us, how primary care specialist are underpaid, of the enormous administrative burden of primary care practitioners, and a range of possible models for implementation. Democrats are listening to the public on the issue of universal access to primary health care. The formidable obstacles to implementation are being looked at closely to enable access to primary health care for every Vermonter.

S.197/Act 173 (An act relating to reform for primary care) intends to establish a program of universal primary care that is accessible and affordable for all Vermonters, to improve population health, reduce costs, and obtain the information necessary to develop a framework for implementation of universal primary care. The bill passed the House and Senate, and was signed into law by the Governor on 18 June 2026.

H.585 (An act relating to health insurance reforms), referred to as “the governor’s bill,” contained some provisions that were unhelpful to health care access and cost containment (such as pre-authorization, association health plans, short-term limited duration plans). The bill also included modifications put forth by the House Health Care  Committee, including:

• site-neutral billing for physical therapists (to see the impact to system costs in the context of, for example, a UVM-affiliated PT provider billing services at many times the rate of a non-UVM-affiliated provider)

• a methodology for certain non-insurance entities (often religious-based, and not subject to regulation) to report on membership charges, payouts, conditions treated and medical care covered. The Department of Financial Regulation is interested in obtaining this information. 

This bill stalled in the Senate.

Medicare payments involving out-patient procedures connected to critical access hospitals:

The Green Mountain Care Board (GMCB) and House Committee on Health Care learned of the extreme over billing occurring by Vermont’s critical-access hospitals, using a mechanism that allows hospitals to overcharge their patients for out-patient procedures by many factors (and at many times the allowable Medicare rate). Vermont hospitals are gouging Vermont seniors. This problem was created by an outdated Medicare rule in combination with contracts negotiated by major national insurance companies that only pay a small percentage of billed charges. The hospitals refused to cooperate in a fix at this time, but are now aware this practice is being scrutinized by the GMCB and the legislature, and there is legislation requiring affirmative disclosures to be developed by the hospitals and GMCB to patients.

2026 Bills that save cost and improve access:

H.577/Act 132  (An act relating to establishing the Vermont Prescription Drug Discount Card Program) relates to Array RX, a non-profit drug-prescription savings card introduced by the State Treasurer, offering low-cost prescription drugs to any person with a Vermont address. Vermont is the sixth state to join the non-profit consortium (Connecticut and Oregon are also members). The Array RX card includes the following features: free to participants; offers generic drugs at about 20% of cost and name-brand drugs at 80%; privacy of enrollees is protected and not sold (unlike other drug for-profit benefit plans); includes compensation for pharmacists in its pricing; counts toward a member’s existing plan deductibles; and is projected to save Vermonters millions of dollars. The bill passed the House and Senate, and was signed into law by the Governor on 15 June 2026.

H.588/Act 119 (An act relating to professions and occupations regulated by the Office of Professional Regulation) allows pharmacists to test for infectious diseases (e.g., Covid) and then prescribe a treatment (e.g., Paxlovid) immediately rather than requiring the patient to make a doctor’s appointment before receiving a prescription. This legislation allows the pharmacists to prescribe the necessary medication in a timely way, improving outcomes and saving unnecessary system-wide costs. The bill passed the House and Senate, and was signed into law by the Governor on 8 June 2026.

S.163/Act 92 (An act relating to the role of advanced practice providers in hospital care) approves and expands the scope of Physician’s Assistants (PAs) and Advanced Practice Nurse Practitioners (APRNs) to be the Medical Attending Officers in hospitals without involving an M.D. This avoids long and unnecessary delays in getting timely care, provides for the responsible health care provider under the Patient’s Bill of Rights, conforms with existing practice, and saves costs to the system. The bill passed the House and Senate, and was signed into law by the Governor on 6 May 2026.

H.237/Act 84 (An act relating to prescribing by doctoral-level psychologists) expands the scope of practice of psychologists to prescribe pharmaceuticals with additional training and certification by the Office of Professional Regulation. This is intended to address the problem of the shortage of psychiatrists in Vermont and allows people suffering from mental illness access to treatment. While the purpose is to access meaningful and timely treatment, this expansion to qualified psychologists also is expected to save costs to the system. The bill passed the House and Senate, and was signed into law by the Governor on 27 April 2026.

H.573 (An act relating to the first certification of an emergency examination) was intended to  expand the scope of practice of Physician’s Assistants (PAs) to allow their performance of first certification in an emergency-room setting for involuntary commitment. PAs are often the only ones at the hospital emergency room and speed is critical in getting patients appropriate medical care. This solves the problem of needing to wait for an M.D. to perform a duplicative role. Including PAs in this role saves costs to the system. This bill stalled in the Senate.

S.142/Act 172 (An act relating to a pathway to licensure for internationally trained physicians) creates a pathway for internationally-trained physicians to become licensed in Vermont. There is an acute shortage of physicians in Vermont.  This bill enables highly-trained physicians already present in Vermont to practice medicine, mostly in much-needed are of primary care. The bill passed the House and Senate, and was signed into law by the Governor on 18 June 2026.

A few more bills, briefly, by subject:

H.84/Act 80 (An act relating to allowing telehealth appointments to be recorded with patient and provider consent) allows Telehealth appointments to be recorded with patient and provider consent. The bill passed the House and Senate, and was signed into law by the Governor on 20 April 2026.

H.814/Act 101 (An act relating to neurological rights and the use of The bill passed the House and Senate, and was signed into law by the Governor on 18 May 2026.

H.816/Act 156 (An act relating to regulating the use of artificial intelligence in the provision of mental health services) regulates the use of Artificial intelligence in mental health services. This legislation ensures that when mental health services are being offered, the clinician (not AI) must make a therapeutic decision, diagnosis, and decide treatment options. AI may be used as a helpful tool only. There are enforcement and penalty mechanisms for violations. The bill passed the House and Senate, and was signed into law by the Governor on 17 June 2026.

H.817 (An act relating to mental health literacy and peer-to-peer supports in schools). This bill passed the House and Senate, but was vetoed by the Governor on 17 June 2026.