Virtually all folks have medical insurance in Vermont, a state famed for its maple syrup and Ben & Jerry’s ice cream, but residents pay the nation’s highest insurance coverage premiums for particular person protection and endure months-long waits for care — and most hospitals listed here are dropping cash, in accordance with state stories and interviews with residents and business officers.
For greater than 15 years, federal and state policymakers have centered on growing the variety of folks insured, which they anticipated would shore up hospital funds and make care extra out there and inexpensive.
“Vermont’s struggles are a wake-up name that insurance coverage is just one piece of the puzzle to making sure entry to care,” stated Keith Mueller, a rural well being skilled on the College of Iowa.
Regulators and consultants say the state’s small, growing older inhabitants of about 650,000 makes spreading insurance coverage threat tough. That demographic problem is compounded by geography, as many Vermonters stay in rural areas, the place it’s tough to draw extra well being staff to deal with shortages.
In contrast to most states, Vermont regulates hospital and insurance coverage costs by means of an unbiased company, the Inexperienced Mountain Care Board. Till not too long ago, the board usually permitted no matter worth modifications firms needed, stated Julie Wasserman, a well being marketing consultant in Vermont.
In September, Bruce Hamory, a marketing consultant employed by the board, really helpful modifications together with doubtlessly changing 4 rural hospitals into outpatient services and consolidating specialty providers at others.
He cautioned that any repair would require sacrifices from everybody, together with sufferers. “There isn’t a easy single coverage answer.”
Lynne Drevik, who runs an inn and spa in northern Vermont, stated her physician instructed her in April that she wanted knee alternative surgical procedures — however the earliest appointment can be in January for one knee and subsequent April for the opposite.
Drevik stated it hurts to climb the steps in her nineteenth century farmhouse. “My life is on maintain right here, and it’s exhausting to make any plans.”
Andy Kehler typically worries about the price of offering medical insurance to the 85 staff at Jasper Hill Farm, the cheesemaking enterprise he co-owns in northern Vermont. The corporate pays half the price of staff’ medical insurance premiums as a result of that’s all it may possibly afford, he stated.
“It’s a difficulty yearly for us, and it seems like there isn’t a finish in sight,” he stated.
Latest knowledge reveals the College of Vermont Well being Community controls about two-thirds of the state’s hospital market, and its essential facility, the College of Vermont Medical Middle in Burlington, has a few of the highest costs nationwide.
Hospital officers contend their costs are common for the business.
However for 2025, the Inexperienced Mountain Care Board required the Burlington hospital to chop the costs it payments personal insurers by 1 p.c.
The nonprofit system says it’s navigating its personal challenges, together with a scarcity of housing to recruit staff and a scarcity of psychological well being suppliers, nursing properties and long-term care providers, which frequently creates delays in discharging sufferers, including to prices.
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