Marketplace has kept health care costs affordable for now

VERMONT— Healthcare insurance premiums in Vermont consistently rank among the highest in the nation.

Paying a health insurance premium is not easy.

For someone over age 30, the cheapest unsubsidized individual plan available from a private health insurance company in Vermont costs $807.97 per month, not including any additional out-of-pocket healthcare expenses, according to Melanie Clark, a Vermont Health Connect Certified Application Counselor in Middlebury.

At that rate, someone making Vermont's minimum wage would have to work over 57 hours to simply pay their monthly premium — so nearly a week and a half on the job each month just to pay for healthcare.

The cost for families is even steeper. Clark said the cheapest unsubsidized family plan in Vermont amounts to $2,270 a month. It would take someone making minimum wage four 40-hour work weeks to pay for the premium alone. This means that one family member would have to work all month simply to pay the family's monthly health insurance premium. This doesn't include the $18,400 out-of-pocket medical costs families in Vermont are liable to face each year.

However, the state government does provide ways for eligible Vermonters to receive financial assistance in paying for health insurance.

Vermont Health Connect, the state government's health insurance marketplace, allows eligible Vermonters to apply for Medicaid or for a qualified health plan. People on qualified health plans receive financial help from the state to help pay for plans managed by private insurance companies Blue Cross Blue Shield of Vermont and MVP Health Care.

According to the Department of Vermont Health Access (DVHA), 32,000 people — an increase of 11% — signed up for health and dental plans through Vermont Health Connect in 2025. It was a record number.

In 2025, DVHA said that an eligible individual earning $40,000 a year qualified for the lowest cost Gold plan for less than $1 a month, saving almost $14,000 a year. Eligible families of four earning $100,000 a year qualified for a Gold plan for $155.37 a month, saving more than $35,000 a year.

2010's Affordable Care Act provides funding from the federal government to help the state subsidize health insurance for Vermonters through Vermont Health Connect. 2021's American Rescue Plan Act modified parts of the Affordable Care Act and provided higher subsidies to individuals eligible to enroll in Vermont Health Connect. According to Clark, these subsidy increases led to more individuals enrolling in qualified health plans through Vermont Health Connect.

However, these federal subsidies, including a federal tax credit known as the Advance Premium Tax Credit, are due to expire at the end of this year unless Congress acts to extend them.

Should the Advance Premium Tax Credit expire, the federal government would no longer subsidize health insurance premiums for households earning less than 400% of the Federal Poverty Level. For a family of four in Vermont, this applies to households making $128,600 or less a year.

"Without subsides from the federal government, even the most basic health insurance plan offered by our carriers would be out of reach for most Vermonters," Clark said.

The U.S. Senate this week was in heated debate over the Trump Administration's "Big Beautiful Bill." If the bill becomes law, it would likely lead to fundamental changes in the way healthcare is funded and provided throughout the country, but especially in rural areas like Vermont. The GOP has also promised sweeping reforms to Medicare and Medicaid, including widespread cuts to medical spending and tighter eligibility requirements that could leave thousands of Vermonters without health insurance.

It is unclear how Advance Premium Tax Credits, or Vermont's larger healthcare subsidy system, might be affected should some version of the Big Beautiful Bill become law. Though it definitely will affect Vermonters.

However, with fewer people insured through Medicaid combined with less money available to subsidize insurance through Vermont Health Connect, the costs of Vermont's already expensive insurance premiums are likely to continue rising.

Clark says that whether Vermonters can pay for health insurance comes down to simple dollars and cents.

"If you were put in the position of choosing between paying for health insurance premiums, groceries, fuel, housing or clothing for your children, what would you choose?" she asked.

"I think it's safe to say that subsidized healthcare is not only important to the health and wellbeing of Vermonters, but essential in today's economy," she said.