Healthcare
Health care remained one of the Legislature’s most difficult affordability challenges. Lawmakers pursued a range of strategies aimed at improving affordability, strengthening primary care, increasing oversight of hospitals, and laying the groundwork for longer-term system reforms. While several scaled back measures advanced, including accelerated reference-based pricing initiatives and prescription drug affordability efforts, broader structural reforms continued to generate significant debate and remain works in progress.
S.190 – Health Care Reform, GMCB Authority, and Cost Containment
Accelerates implementation of reference-based pricing (RBP), a hospital cost-control strategy first authorized in Act 68 of 2025. The bill requires the Green Mountain Care Board (GMCB) to implement RBP for VEHI plans and Vermont Health Connect Qualified Health Plans before broader statewide implementation. It also establishes a framework to gradually reduce Vermont hospital prices toward national median levels, requires additional reporting on hospital outsourcing, and authorizes pursuit of a federal reinsurance waiver. The Administration has raised concerns that the RBP savings would benefit certain populations rather than all Vermonters.
S.197 – Primary Care Investment and Health System Transformation
Lays the groundwork for future primary care reform by directing state agencies to develop recommendations on primary care spending targets, payment reform, Blueprint for Health expansion, and a potential universal primary care model. The bill’s primary policy changes require participating commercial insurers to make Blueprint payments at least equal to Medicaid rates beginning in 2027 and require 60 days’ notice before removing prescription drugs from formularies.
S.189 – Hospital Service Elimination requirements
Establishes a formal review and public engagement process before hospitals eliminate essential services such as emergency care, obstetrics, psychiatric services, dialysis, or primary care. Hospitals must notify regulators, provide public notice, hold hearings, and solicit community input before proceeding. The bill does not prohibit service reductions but increases oversight and transparency.
H.577 – Vermont Prescription Drug Discount Program (ArrayRx)
Creates a statewide prescription drug discount card program administered by the State Treasurer. The program allows Vermont to leverage multi-state purchasing arrangements to reduce prescription drug costs and ensures that eligible discounts count toward a participant’s deductible and out-of-pocket maximums.
H.582 – Adult Protective Services Modernization
Modernizes Vermont’s Adult Protective Services laws by updating definitions, clarifying reporting requirements, improving coordination with professional licensing entities, and refining appeal procedures. The legislation is intended to strengthen oversight and improve responses to abuse, neglect, and exploitation of vulnerable adults.
H.84 – Telehealth, Ambient Documentation, and Patient Consent
Allows telemedicine and telephone health care consultations to be recorded when both the patient and provider consent. Signed by the Governor on April 20, 2026.
H.545 – Immunization Recommendations
Temporarily transfers authority for Vermont’s recommended immunization schedules from the federal ACIP process to the Commissioner of Health through July 1, 2031. The bill also updates related vaccine administration, insurance, and pharmacy provisions.
H.583 – Restrictions on the “corporate practice of medicine”
Strengthens Vermont’s restrictions on corporate influence over medical decision-making by limiting arrangements that allow non-licensed entities to direct or control clinical care. The bill establishes new requirements for management services organizations (MSOs), ownership structures, disclosures, and enforcement.
H.237 – Prescribing Psychologists
Governor Scott has signed H.237, which creates a pathway for licensed doctoral-level psychologists to obtain a prescribing psychologist specialty certification. To qualify, psychologists must complete advanced postdoctoral training, supervised clinical experience, and certification requirements established by the Board of Psychological Examiners. Prescribing psychologists must maintain a collaborative agreement with a Vermont-licensed psychiatrist, and their authority is limited to mental health medications. Supporters viewed the measure as a way to expand access to mental health care, particularly in underserved areas. The law also requires a report to the Legislature by November 2032 evaluating the program’s effectiveness.
