Federal cuts will affect health care costs and coverage

COMMENTARY

BY DA SHAWN GROVES Vermont remains a nationwide leader in health coverage - we've got to stay focused on maintaining our progress.

For the better part of a year, I have had the privilege of serving as commissioner for the Department of Vermont Health Access, which administers Vermont Medicaid and the health insurance marketplace through VT Health Connect.

At a time of great uncertainty in our health care landscape, Vermont continues to be a nationwide leader in health coverage. According to the recent Vermont Household Health Insurance Survey, 97 percent of Vermonters are enrolled in health coverage and Vermont's "underinsured" rate dropped significantly since 2021. The survey results show that our brave little state, amazingly, emerged from the pandemic with stronger, more stable coverage than we had going in.

This doesn't happen by chance. It's the result of years of thoughtful policy, relentless coordination, and a shared commitment to making sure Vermonters can get the care they need. Vermont has long had one of the lowest uninsured rates in the country, and that trend continues in 2025 with only 3 percent of Vermonters lacking any health coverage.

This is in the context of the Medicaid renewal process that DVHA conducted following the COVID-19 pandemic, which redetermined eligibility for all members enrolled through Medicaid. It is an encouraging sign for Vermont's insurance landscape that many Vermonters maintained their Medicaid enrollment or transitioned to the health insurance marketplace during this time.

From 2021 to 2025, all measures of Vermonters' health insurance coverage are trending positively or are holding steady over time. These are important, and encouraging, trends. Insured Vermonters are more likely to visit a doctor, seek preventative care, and have better health outcomes than those without health coverage. However, we cannot ignore the fact that the cost of health care, for the average Vermonter, continues to increase and that trend impacts both Medicaid and the marketplace.

One indicator of Vermont's insurance landscape is the shrinking percentage of Vermonters who are considered "underinsured," meaning they are enrolled in a health plan but still have significant expenses not covered by their insurance. In 2021, Vermont's underinsured rate was 40 percent. Today, that has dropped to 31 percent. This represents a significant improvement in ensuring Vermonters are enrolled in plans that meet their needs.

This is likely a result of more robust plans being available at lower costs due to enhanced federal premium tax credits. For 2025, DVHA helped enroll Vermonters in qualified health plans with higher levels of coverage but lower monthly premiums because of this increased availability of federal funds. This practice has allowed thousands of Vermonters to move into better plans at lower out of pocket costs and has resulted in record enrollment through Vermont's health insurance marketplace.

We need to maintain our progress and our position as a nationwide leader in health insurance coverage.

This coming year, Vermont will see changes in the availability of federal subsidies. Enhanced subsidies, which have helped keep monthly premiums affordable for thousands of Vermonters, are set to expire at the end of 2025. That change, in addition to new eligibility requirements included in the federal budget, may impact our uninsured and underinsured rates here in Vermont.

Vermont has been, and continues to be, a nationwide leader in health coverage.

At the Department of Vermont Health Access, we have been acutely aware of the health care affordability crisis facing Vermonters, with rising costs for health care services and health care coverage. This moment calls for creative solutions, strategic partnerships, and a shared commitment across leadership to protect what we've built. While we don't know the full extent of the impact changes at the federal level will bring, the Department of Vermont Health Access remains committed to improving Vermonters' health and well-being by providing access to high-quality health care.

Dr. DaShawn Groves is the Commissioner for the Department of Vermont Health Access. The opinions expressed by columnists and op-ed writers do not necessarily reflect the views of Vermont News & Media.