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Read. Follow. Verify.Vermont House Bill 433 establishes incremental 10-year implementation of Green Mountain Care universal health program
Last action · February 28, 2025: Read first time and referred to the Committee on Health CareSponsors: Brian Cina and 26 others
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What This Bill Would Do
This bill initiates the phased implementation of Green Mountain Care, a publicly financed health care program for all Vermont residents, starting with primary care, outpatient mental health, substance use disorder treatment, and vaccines in year one, preventive dental and vision care in year two, and additional services over ten years. The measure creates a Universal Health Care Advisory Group at the Green Mountain Care Board, prohibits health plans from duplicating Green Mountain Care coverage, and sets a target implementation start date of January 1, 2027.
Vermont residents will see a gradual expansion of publicly financed health benefits over a decade, starting with cost-sharing-free primary and preventive services in the first year and potential future funding via payroll and income tax surcharges.
Who It Would Affect
Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.
Vermont residents
Vermont residents will receive incrementally expanding, publicly financed health care coverage over a 10-year period beginning with primary, dental, and vision services.
Health care professionals
Health care professionals must submit claims electronically and will be subject to a single, standard reimbursement rate based on a percentage of Medicare for fee-for-service care.
Health insurers
Insurers are prohibited from offering health insurance plans or rates that reflect duplication of coverage provided by Green Mountain Care.
Employers
Employers may be subject to a payroll tax levied to finance Green Mountain Care under the General Assembly's statement of intent.
Key Facts
- Green Mountain Care will be implemented 90 days after receiving a Section 1332 ACA waiver, enacting initial appropriations, and determining through analysis that residents will receive benefits with an actuarial value of 80% or greater without a negative aggregate economic impact.
- In the first year of implementation, Green Mountain Care will cover all primary care services (including outpatient mental health and substance use disorder treatment), communicable disease testing, and CDC-recommended vaccines with zero cost-sharing.
- In the second year, coverage expands to include prophylactic dental services, annual vision exams with glaucoma and macular disease screening, and medically necessary hearing aids, all with zero cost-sharing.
- Services for years three through 10 will add maternal and neonatal care, standard diagnostic screenings, medically necessary dental services, emergency services, physical therapy, durable medical equipment, specialty care, home health, hospice, and inpatient hospital care.
Show all 10 facts
- The bill creates a Universal Health Care Advisory Group within the Green Mountain Care Board to report annually on sequencing, financing, co-payments, and benefit additions.
- The General Assembly states its intent that Green Mountain Care may be financed through an employer payroll tax, self-employment income tax, and an income tax surcharge deposited into the Green Mountain Care Fund.
- Green Mountain Care will serve as the payer of last resort for any health service covered in whole or in part by other health benefit plans, including Medicaid, CHIP, Medicare, private insurance, and federal military or employee plans.
- Health care professionals submitting fee-for-service claims will be reimbursed at a single, standard rate established by the Agency based on a percentage of the Medicare rate.
- The first year of Green Mountain Care's implementation is intended to begin on January 1, 2027.
- The act takes effect on July 1, 2025.
Frequently Asked Questions
What health services are covered in the first year of Green Mountain Care?
Will individuals be required to drop their existing health insurance or Medicare?
How will Green Mountain Care be funded?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Currently in committee. The next step in the legislative lifecycle is Floor Vote.
Procedural history
1 action- Feb 28, 2025HouseIntroducedRead first time and referred to the Committee on Health Care
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Show 22 more sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Decennial Incremental Transition to Universal Health Care
The legislation structures health reform as a strict 10-year phased roadmap, explicitly separating early years (primary, dental, vision) from later years (inpatient, specialty care) based on advisory board recommendations.
Connected Entities
Sources
legislature.vermont.gov
Analysis Score
0–100- Significance85How much this matters to a regular citizen
- Controversy80Intensity of disagreement among stakeholders
- Entertainment10Compellingness for a non-policy-wonk reader
- Buzz45Current news / social attention level
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