
Gov. Phil Scott has chosen to address Vermont’s health care affordability crisis in seemingly the only way he knows how: By proposing a modest deregulation of the marketplace.
The situation as we know it: Health insurance costs are skyrocketing and have been for years. Like many other challenges we face, it’s gotten worse during Scott’s time in office. It’s hitting everybody in the pocketbook. It’s driving the increase in property taxes and putting the squeeze on government operations. Our hospital system is close to collapse. Well, except for the University of Vermont Medical Center, which has become the designated whipping boy for rising costs.
And now we’re facing a dramatic rise in uninsured Vermonters thanks to the Republican Congress’ termination of federal subsidies. Per VTDigger’s Olivia Gieger, more than 2,500 Vermonters have already dropped their insurance plans — a decline of nearly eight percent. In the first two weeks of no federal subsidies!
And a Department of Vermont Health Access official has said that even more people will decide to go bareback as they face the harsh reality of through-the-roof premiums.
This is terrible news for our struggling hospitals, which will almost certainly have to absorb higher costs for charity care as uninsured Vermonters avoid seeing the doctor until they resort to the most expensive kind of care there is — emergency room visits.
Last fall the Green Mountain Care Board received a consultant’s report that described our health care system (does it really qualify as a “system”?) as “badly broken” and in need of immediate, wide-ranging structural reform. “Many hospitals are already on the edge of financial unsustainability,” consultant Bruce Hamory told the Board.
And now we’re about to throw truckloads of uninsured, desperate Vermonters onto the backs of those hospitals? Great.
Has the Scott administration proposed any sort of relief or reform for our hospitals? If so, they’ve been awfully quiet about it.
But hey, the administration has proposed a regulatory reform measure that could cut insurance rates by… an aggregate of five percent. If it works as intended.
Whoopee doopee!
But wait, there’s more. The reforms would allow insurers to offer different rates for different age groups, which would tend to help younger Vermonters but make older folks pay more. It would also allow the sale of association health plans. Per Vermont Public’s Lola Duffort, such plans are “popular among conservative policy-makers,” a phrase that makes me reflexively clench my fist around my wallet.
Vermont Health Advocate Mike Fisher told lawmakers last week that he could support the Scott plan if it could improve the viability of Vermont’s insurance pool, but that a five percent differential “was unlikely to drive change.” And Green Mountain Care Board chair Owen Foster, a Scott appointee, expressed skepticism. “I don’t think I’ve seen or heard of any data suggesting that this will actually change the behavior,” he told the House Health Care Committee.
So this is what we get from our brave, bold governor in the face of a crisis in the health care system: A market-oriented insurance reform plan unlikely to move the needle in any meaningful way. And a system already “badly broken” and near collapse now faces a tsunami of uninsured Vermonters. As I wrote about Scott’s budget address last month:
He did try to pretend there was new wine in those old, moth-eaten wineskins but it wasn’t nearly enough to persuade. Every governorship has an expiration date, and this speech was one more sign that Scott’s has come and gone.
My conclusion to that post serves this one just as well.
I tell you what, the next governor is going to have a massive job on their hands to clean up all the messes Scott leaves behind and all the crises he’s allowed to get worse and worse.

Phil needs to put on his big boy pants and convene with the rest of the northeastern states governor’s and work through a regional solution.
especially since the majority of hospitals are dealing with cost changes by (checks notes) increasing Ortho space for seniors
i get we have a lot of old people, but there’s only so many hips and knees
Procedure-oriented medicine is good business. Compare the earning power of surgeons or heart specialists to pediatricians or psychiatrists or family docs.
the state and regions continuously push that they want young people to move here and then knee cap themselves when they allow hospitals to cut services that support those folks.
yes, procedure oriented medicine is good money, but only because Medicaid and Medicare prioritize those payments.
when *every* small hospital in the region starts pushing procedure based medicine and reducing services, they’re creating care deserts while over covering the region.
Right. That’s why Woodin canned the Copley birthing center. Babies are a loss leader, geezers with lousy knees are a boon.
Apologies for citing myself, but….
“I once described our current efforts at health care “reform” as analogous to a group of people watching a house burn. Though they are gathered around a fire hydrant and a hose is coiled at their feet, they ignore both and endlessly discuss how they might make it rain to put the fire out. Maybe prayer would work? A rain dance? Seeding the clouds? The house continues to burn.
“The disease — the fire — is the horrendous complexity and waste that permeates health care, driving the overall cost of health care ever higher. The administrative costs in our system —the time and money spent just operating the system — are outrageous and we have known that for a very long time.”
https://vtdigger.org/2024/07/25/lee-russ-how-much-longer-can-we-ignore-the-real-health-care-problem/
Hey, I cite myself all the time. No problem.
“A market-oriented insurance reform plan unlikely to move the needle in any meaningful way.”
Ahh, but the insurance CEOs will love it, the campaign donations will keep rolling in, and that’s all that matters.