A joint hearing of the Senate Health and Welfare and House Health Care Committees made it clear that Vermont’s healthcare system is beyond warning signs—it is in active crisis. Testimony from the Green Mountain Care Board (GMCB), Agency of Human Services (AHS), and hospital leaders revealed a system in financial freefall, with both insurers and providers facing mounting pressure from solvency threats, skyrocketing costs, and growing gaps in care access.

Leaders from across the healthcare landscape shared stark realities: more than half of Vermont’s hospitals are operating at a loss, and Blue Cross Blue Shield of Vermont, the state’s only remaining domestic insurer, is under analysis by the Department of Financial Regulation (DFR). One number captured the urgency: $200 million. That is the amount BCBSVT says it needs by July to avoid double-digit premium increases and to cap 2025 rate hikes at 5%. Without it, businesses and their employees could face yet another year of devastating cost escalation.

In a critical moment of testimony, GMCB member Jessica Holmes articulated the unsustainable load employers have carried: Vermont’s declining commercial population is shouldering a disproportionate burden because the system “has essentially been financed by the high prices paid by the commercially insured population and their employers. They cannot afford to do so any longer.” Her comments underscored the central tension in the crisis—businesses are being priced out of a system that relies on their continued contributions to stay afloat.

Senate Reviews an Emergency Powers Bill, Passed by the House

The Senate Health and Welfare Committee is reviewing H.482, a House-passed bill that gives the Green Mountain Care Board temporary emergency powers to stabilize Vermont’s healthcare system.

One provision would allow the Board, with input from the Department of Financial Regulation, to reduce insurer payments to hospitals if a domestic insurer faces an “acute and immediate” solvency threat. Reductions would apply only to hospitals with over 135 days cash on hand and a recent operating surplus. Testimony questioned the fairness and accuracy of this metric, with some calling for a higher threshold and exemptions for Critical Access Hospitals.

A second provision would let the Board appoint an independent observer if a hospital misrepresents financial data or breaks its budget. Hospital leaders warned this could hurt bondholder confidence. Lawmakers are considering clearer definitions and safeguards to avoid unintended financial harm.

Who’s in Charge?

Even as the crisis intensifies, fundamental questions persist: Who is responsible for making the decisions that will prevent system collapse this summer? Oversight is fragmented among the Legislature, the Governor’s administration including the Agency of Human Services and DFR, and the GMCB, leaving no single entity clearly empowered to intervene in ensuring the balance between insurance solvency and support for hospital systems that are critical to communities, at the speed the moment requires.

The lack of a designated crisis authority has fueled concern among lawmakers and advocates alike. Vermonters and Vermont employers deserve clarity on who holds the reins. Without decisive leadership and accountability, the system’s stability and the financial wellbeing of the state’s business community remain at risk.

Impact on Vermont Employers

Without intervention, Vermont employers could face premium increases of 20% or more for a fourth consecutive year. That would force businesses to reduce benefits, shift more costs onto employees, or forgo coverage altogether. At the same time, staffing shortages, care delays, and hospital instability could hinder employee health and hiring efforts statewide. The Vermont Chamber remains deeply concerned  about the economic ripple effects. The business community cannot continue to subsidize a collapsing system without support or reform.