VermontVermont insurers share care data and help fund primary care
Vermont law requires insurers to share care data, pay the Blueprint for Health starting in 2027, and warn some patients before drug coverage ends.
What it does
Health insurers send information to state officials at least every three months. Starting in 2027, they also pay the Blueprint for Health at least as much as Medicaid pays it.
Insurers give at least 60 days’ notice before ending coverage for a drug to covered people who filled a prescription for it during the past year.
State officials report on primary care spending and set a target for how much monthly health spending should go to primary care, with a schedule for raising it.
State agencies review who should handle health care rules and reform work. Other state offices recommend ways to move patients from hospitals to community care and explore a possible regional primary care program.
Argument forShared care data and spending targets could help Vermont plan payments and resources around primary care needs.
Argument againstQuarterly reporting and payments at least as large as Medicaid’s may add work and expenses for health insurers.
More detail
Health insurers send information to the Agency of Human Services at least quarterly and pay the Blueprint for Health starting in 2027. The information helps the Blueprint analyze total care costs and develop payment models that address health care capacity, volume, quality, and clinical outcomes. The payments must be at least equal to the payments from Medicaid. Insurers provide information at least quarterly. The payment requirement starts in 2027.
Insurers give advance notice when they plan to stop covering a drug. The notice applies when an insurer plans to eliminate coverage for a particular drug. Notice goes to covered people who filled a prescription for that drug during the previous year. The notice must be given at least 60 days before coverage ends.
State health agencies report on primary care spending and recommend a target and a schedule for raising it. The spending report covers Vermonters overall and by payer; the target concerns the share of per-person monthly spending on Vermont residents that should go to primary care. The Agency of Human Services consults the Green Mountain Care Board on the spending report and consults the Department of Taxes on a proposed process for using the health care claims tax to fund the Blueprint. The spending report is due January 15, 2027. The target and schedule are due January 1, 2028. The Blueprint director also reports on needed payment changes by January 15, 2027.
State agencies review how health care regulation and reform work should be divided and report recommendations; other state offices make further reports and explore a regional program. The review involves AHS, the Green Mountain Care Board, and the Department of Financial Regulation. AHS also reports on moving patients from hospital care to community care. The Treasurer explores the regional program with other Northeastern states. AHS incorporates hospital-to-community transition recommendations into the Health Care Delivery Strategic Plan as appropriate. These recommendations and the regional program report are due to the General Assembly by January 15, 2027.
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Where it stands
- Introduced
- Passed 1st Chamber
- Passed 2nd Chamber
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- May 29Senate Message: Signed by Governor Phil Scott June 18, 2026Latest
- May 29Signed by Governor Phil Scott on June 18, 2026Became Law
- May 29Delivered to Governor on June 12, 2026To Governor
- May 26Senate Message: House proposal of amendment concurred inMinor
- May 26Rules suspended & messaged to House forthwith, on motion of Senator Baruth
- May 26Title amended
- May 26As passed by Senate and HouseMajor
- May 26House proposal of amendment concurred inMinor
- May 26House proposal of amendment; textMinor
- May 26House proposal of amendmentMinor
- May 22House proposal of amendmentMinor
- May 22Entered on Notice Calendar
- May 21House message: House passed bill in concurrence with proposal(s) of amendment
- May 20Rules suspended and bill messaged forthwith to the Senate as moved by Rep. McCoy of Poultney
- May 20Read third time and passed in concurrence with proposal of amendmentPassed 2nd Chamber
- May 20Rules suspended and bill placed in all remaining stages of passage as moved by Rep. McCoy of Poultney
- May 20Third Reading orderedMinor
- May 20Report of Committee on Health Care, as amended, agreed to
- May 20Rep. Kornheiser of Brattleboro and Kimbell of Woodstock moved to amend the report of the Committee on Health Care, which was agreed to
- May 20Rep. Yacovone of Morristown recommended for the Committee on Appropriations
- May 20Rep. Holcombe of Norwich recommended for the Committee on Ways and Means
- May 20Rep. Goldman of Rockingham reported for the Committee on Health Care
- May 20Read second timeMinor
- May 20Rules suspended and taken up for immediate consideration, pending entry on Notice Calendar, as moved by Rep. McCoy of Poultney
- May 19Pending entry on Notice Calendar, referred to Committee on Appropriations per Rule 35(a)
- May 19Referred to Committee on Ways and Means per Rule 35(a)
- May 19Action Calendar: Favorable with Amendment
- May 18Notice Calendar: Favorable with Amendment
- Mar 27Read first time and referred to the Committee on Health CareMinor
- Mar 25Read 3rd time & passedPassed 1st Chamber
- Mar 25New Business/Third ReadingMinor
- Mar 24Title amended as recommended by Committee on Health and Welfare
- Mar 243rd reading ordered
- Mar 24Recommendation of amendment by Committee on Health and Welfare agreed to
- Mar 24Reported favorably by Senator Lyons for Committee on AppropriationsMinor
- Mar 24Read 2nd time, reported favorably with recommendation of amendment by Senator Lyons for Committee on Health and WelfareMinor
- Mar 24Favorable report with recommendation of amendment by Committee on AppropriationsMinor
- Mar 24Favorable report with recommendation of amendment by Committee on Health and WelfareMinor
- Mar 24Second ReadingMinor
- Mar 20Favorable report by Committee on AppropriationsMinor
- Mar 20Favorable report with recommendation of amendment by Committee on Health and WelfareMinor
- Mar 20Second ReadingMinor
- Mar 20Entered on Notice Calendar
- Mar 17Referred to Committee on Appropriations per Senate Rule 31
- Mar 17Favorable report with recommendation of amendment by Committee on Health and WelfareMinor
- Mar 17Second ReadingMinor
- Mar 17Entered on Notice Calendar
- Jan 6Read 1st time & referred to Committee on Health and WelfareIntroduced
Healthcare