by Devon Green, VP of Government Relations, VAHHS And just like that, we’re already staring down the barrel of crossover on March 14. This week will be extremely busy, as policy committees work on their budget priorities and advancing bills before they go home for Town Meeting week. Below is the activity that happened last week:
Health Care Reform: VAHHS testified on the Senate Health and Welfare committee bill outline and supported a statewide plan with stakeholder oversight, including a VAHHS nominee to the advisory committee. In moving forward, VAHHS would like to understand where the Act 167 feasibility work with the Rural Health Redesign Center fits into the planning, and noted government overreach in a requirement for approving hospital strategic plans.
VAHHS also echoed Dr. Nancy Kane’s previous testimony that Vermont already has audited financials and now needs the financial literacy to understand the data. The Vermont Medical Society, HealthFirst, and Bi-State supported funding for primary care. The Health Care Advocate testified that it was unrealistic to think the federal government would honor the AHEAD agreement and that the committee’s priority should be reference-based pricing. On Friday, the Senate Health and Welfare Committee heard from Milbank Memorial Fund Chair John Colmers, Dartmouth PhD candidate Alena Berube, and Dr. Elliott Fisher from the Dartmouth Institute on the Maryland all-payer model and health care economics.
Certificate of Need: The House Health Care Committee is landing on a Certificate of Need (CON) bill that would increase jurisdictional thresholds to $10 million for construction, $5 million for equipment, and $3 million for new services. The Committee is also exempting replacement equipment that has fully depreciated and provides an expedited process for government projects. They are expected to vote on H.96 this week.
Primary Care Funding: The Vermont Medical Society testified on behalf of VAHHS, Bi- State and HealthFirst in House Health Care on doing no harm to primary care for 2026 and maintaining Vermont’s primary care supportive programs for the gap year between the end of the All Payer Model and the beginning of the AHEAD model.
Medical Debt: VAHHS testified in support of S.27, a bill that lifts the prohibition of hospitals selling medical debt if the debt is sold to a non-profit organization that eliminates debt. VAHHS reminded the committee that it is leaving federal dollars on the table by not fully funding the Disproportionate Share Hospital (DSH) payments, which go towards subsidizing uncompensated care in hospitals. The Health Care Advocate also supported S.27 and further DSH funding.
Freestanding Birth Centers: The Senate Health and Welfare Committee discussed S.18, a bill that would license freestanding birth centers and exempt them from the Certificate of Need process. VAHHS reiterated its position supporting sustainable Medicaid reimbursements for all birthing services and requiring freestanding birth centers to accept Medicaid.
Reference Based Pricing: The House Health Care committee heard about Oregon and Montana’s reference-based pricing programs. Montana’s program was limited to state employees and emphasized the importance of transparency and stakeholder engagement. Oregon noted savings, but also testified that they exempted smaller hospitals due to considerations around volume, access to the community and recognition of the cost-based reimbursement of Critical Access Hospitals.
FY 2026 Budget: The House Health Care Committee took testimony from the Health Care Advocate, who supported permanently funding the Bridges to Health Program and also supported drawing down federal dollars through Disproportionate Share Hospital payments and increasing Medicaid rates for birthing services. The Health Care Advocate also supported primary care and increased payments for birth centers.
Green Mountain Care Board Budget: The House Health Care Committee heard from the Green Mountain Care Board on its proposed budget. After staying fairly flat, the proposed budget includes a 17% increase over last year’s appropriation for an additional three positions to focus on quality and access and noted that it will increase billing to hospitals to make up for the loss of revenue from OneCare Vermont. The Green Mountain Care Board also requires an additional five positions to support moving forward with the AHEAD model.
Budget Adjustment Act: The Senate Appropriations Committee advanced H.141, the FY25 Budget Adjustment Act, including adding reporting requirements to the $10M provider stabilization fund.
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