A Resources Timeline for Vermont Reforms

Pre-2010

1989 - Dr. Dynasaur, a publicly funded insurance program for kids, is enacted

1998 - The Office of the Health Care Advocate is created

2003 - The Blueprint for Health is launched, aiming to better integrate care

2010

The Patient Protection and Affordable Care Act (ACA) is passed

2011

Act 48 creates the Green Mountain Care Board (GMCB). The group is tasked with employing regulation, innovation and program evaluation to ensure that changes to the health system improve quality while stabilizing costs.

(see: reports produced by the Green Mountain Care Board)

2012

Act 171 enacts insurance market adjustments, malpractice reform and ACA compliance measures.

2013

The GMCB assumes responsibility for VHCURES, the state’s all-payer claims database.

The state is awarded a State Innovation Model (SIM) grant from CMS. The four-year grant aims to expand and integrate innovative provider payment and health information technology that supports more effective and efficient care delivery.

2014

After 3 years of study, Vermont abandons its plan for a single-payer system due to cost concerns.

News Coverage:

• The Demise of Vermont’s Single-Payer Plan, NEJM, 2015

• Six Reasons Why Vermont's Single-Payer Health Plan Was Doomed From The Start, Forbes, 2014

• Lessons from Vermont's Health Care Reform, NEJM, 2013

Advocates, including Vermont Health Care for All, continue to push for single payer and universal coverage (see 2016 activity).

2015

Act 54 commissions the study of an all-payer model to be enacted through a CMS waiver.

The Office of the Health Care Advocate publishes a set of Consumer principles for Vermont’s All Payer Model

2016

Act 113 funds a study of the potential expansion of the Dr. Dynasaur program to cover those up to age 26. It separately commissions the study of a program to provide universal primary care.

In a setback, the Supreme Court holds in Gobeille vs. Liberty Mutual that federal law prevents states from compelling self-funded insurers to report their data to all-payer claims databases.

Despite the adverse ruling, advocates continue to strategize on potential next steps in order to sidestep the ruling.