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Vermont House considers Medicaid expansion plan for pregnant Vermonters and young adults

Two women sit at a wooden table
Peter Hirschfeld
Vermont Public
House Speaker Jill Krowinski, left, and Essex Junction Rep. Lori Houghton want to increase access to health care by expanding eligibility for Medicaid.

House lawmakers say they’ll pass legislation later this month that sets the stage for a dramatic expansion of publicly funded health care in Vermont.

Vermont’s Medicaid program is already the largest health insurer in the state, with nearly 200,000 low-income Vermonters enrolled. A bill that’s currently sitting in the House Committee on Health Care seeks to eventually expand eligibility for Medicaid to middle-class residents making up to 312% of the federal poverty level — about $94,000 for a family of four.

“We need a health care vision,” said Rep. Lori Houghton, the Democratic chair of the House Health Care Committee. “We do not have one in the state right now.”

Houghton said the percentage of Vermonters who are underinsured — they have a private premium but can’t always afford the co-pays and deductibles needed to access care — hit 40% this year. That’s up from 30% a decade ago, and House Speaker Jill Krowinski said Thursday that the number will continue to grow if elected officials don’t intervene.

“We know that the rising cost of health care is a problem for so many families and businesses across the state,” Krowinski said. “And this has been a hard policy topic here in Montpelier around health care reform.”

Houghton said Vermont’s Medicaid program provides a solid platform from which to expand access to health insurance.

“It works for Vermonters. It provides the care we need. It makes sure people can get in the door and have care at a preventative point rather than waiting until it’s much worse,” she said. “And so looking at expanding Medicaid will ensure that we’re providing to Vermonters the care that they need.”

The legislation would expand Medicaid eligibility starting next year for pregnant people and individuals between the ages of 19 and 26 who earn up to 312% of the federal poverty level. It also calls for a technical analysis to determine how the state could expand eligibility for all adults; Houghton said that analysis will provide lawmakers with the information they need to move forward with a more ambitious Medicaid expansion during the next legislative session.

Houghton said the Legislature also wants to increase Medicaid reimbursement rates to health care providers. Doctors and other providers say existing reimbursement rates don’t cover the cost of care.

The Scott administration has expressed concern about the financial impact of expanding eligibility for government-funded insurance programs, because associated costs would ultimately be borne by Vermont taxpayers.

Houghton said she doesn’t know yet how many Vermonters would be newly eligible for Medicaid under the proposal, or how much more state funding the expansion would require. But she said the state is in many cases already incurring the costs of care for uninsured and underinsured Vermonters. And she said increasing access to preventative care could reduce overall expenditures.

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The Vermont Statehouse is often called the people’s house. I am your eyes and ears there. I keep a close eye on how legislation could affect your life; I also regularly speak to the people who write that legislation.
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