Vermont Hospitals Propose Budget Adjustments Amid Health Insurance Affordability Crisis: What It Means for You

This month, hospitals in Vermont presented their annual budgets during public hearings. Most of these proposals were in line with state guidelines, showing a shift from the past two years when many hospitals exceeded budget growth limits set by the Green Mountain Care Board.

The hearings reviewed budget requests for 2026 from 14 hospitals, with the fiscal year beginning on October 1. This year’s discussions occur against a backdrop of a healthcare affordability crisis. Insurers are facing financial struggles, and Vermonters continue to pay some of the highest health premiums in the U.S.

The Green Mountain Care Board has set specific growth limits for this year: a 3.5% cap on net patient revenue increases and a 3% cap on operational expenses. They are also reviewing how much hospitals can charge commercial insurers, setting a benchmark for a 3% increase in the amount hospitals can request. Vermont’s healthcare system reflects broader economic trends, making it vital to address these issues to prevent people from being priced out of care.

Mike Fisher, Vermont’s Chief Health Care Advocate, highlights the importance of regulation. He points out that high infrastructure costs, alongside insurer decisions, shape healthcare accessibility. “People should not have to choose between care and affordability,” he said. According to a recent survey by the Kaiser Family Foundation, nearly 30% of Americans reported delaying or avoiding medical care due to costs. This trend echoes concerns in Vermont, where many residents share similar struggles.

A significant change on the horizon is a new law that caps how much hospitals can charge insurers for certain outpatient drugs. This policy, affecting mainly cancer treatments, begins in 2026 and could reduce hospital revenues by about $100 million. Notably, the University of Vermont Medical Center, the state’s only academic medical center, stands to experience the most significant revenue hit of roughly $70 million.

Fisher noted, “We need healthcare leaders to continually evaluate pricing structures for sustainability.” He appreciates initiatives aimed at setting reasonable price limits and believes that collaboration is necessary to find effective solutions. “It is a complex issue, and finding a balance will take time,” he added.

The hearings wrap up soon, and the Green Mountain Care Board will decide by September 15 whether to accept, adjust, or reject hospital budget requests. Recently, Michael Del Trecco, CEO of the Vermont Association of Hospitals, supported hospitals’ budget requests, emphasizing that they are making efforts to address the affordability crisis. He advocates for payment models that promote sustainable healthcare rather than relying solely on rate restrictions, which he believes could hinder transformation efforts.

In summary, these hearings reflect broader societal issues concerning healthcare access and affordability. As Vermont navigates this crucial period, the decisions made now will have lasting impacts on the health and wellbeing of its residents.

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Blue Cross and Blue Shield of Vermont,Green Mountain Care Board,health care,Mike Fisher,Northwestern Medical Center,University of Vermont Health Network,Vermont Association of Hospitals and Health Systems