Vermont 2025-2026 Regular Session

Vermont Senate Bill S0001 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	BILL AS INTRODUCED S.1
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5	5	VT LEG #378801 v.1
6	6	S.1 1
7	7	Introduced by Senators Vyhovsky, Gulick, Watson and White 2
8	8	Referred to Committee on 3
9	9	Date: 4
10	10	Subject: Health; Medicaid; eligibility 5
11	11	Statement of purpose of bill as introduced: This bill proposes to provide 6
12	12	Medicaid-equivalent coverage to all Vermonters by age bands over time, 7
13	13	regardless of household income. It would direct the Agency of Human 8
14	14	Services to seek approval for federal financial participation in the expanded 9
15	15	coverage, with the State paying the full amount if the federal government does 10
16	16	not approve the request. The bill would direct the Agency of Human Services 11
17	17	and others to develop cost estimates for the Medicaid-equivalent coverage and 12
18	18	a detailed implementation plan. The bill would also require the Department of 13
19	19	Taxes to report on potential payroll tax design options to support the State’s 14
20	20	financial obligation in providing the Medicaid-equivalent coverage, both with 15
21	21	and without the federal funding. 16
22	22	An act relating to providing Medicaid-equivalent coverage to all 17
23	23	Vermonters 18 BILL AS INTRODUCED S.1
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27	27	VT LEG #378801 v.1
28	28	It is hereby enacted by the General Assembly of the State of Vermont: 1
29	29	Sec. 1. 33 V.S.A. chapter 18, subchapter 3 is added to read: 2
30	30	Subchapter 3. Medicaid-Equivalent Coverage 3
31	31	§ 1851. MEDICAID-EQUIVALENT COVERAGE FOR ALL VERMONT 4
32	32	RESIDENTS 5
33	33	The Agency of Human Services shall provide hospital, medical, dental, and 6
34	34	prescription drug coverage equivalent to coverage in the Vermont Medicaid 7
35	35	state plan to all Vermont residents, regardless of their household income, as 8
36	36	follows: 9
37	37	(1) to individuals up to 26 years of age, for coverage beginning in 2029; 10
38	38	(2) to individuals who are not less than 55 years of age and not more 11
39	39	than the age of eligibility for the federal Medicare program, for coverage 12
40	40	beginning in 2030; 13
41	41	(3) to individuals who are not less than 45 years of age and not more 14
42	42	than 54 years of age, for coverage beginning in 2031; 15
43	43	(4) to individuals who are not less than 35 years of age and not more 16
44	44	than 44 years of age, for coverage beginning in 2032; and 17
45	45	(5) to individuals who are not less than 26 years of age and not more 18
46	46	than 34 years of age, for coverage beginning in 2033, at which time all 19
47	47	Vermont residents shall be eligible for coverage. 20 BILL AS INTRODUCED S.1
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51	51	VT LEG #378801 v.1
52	52	Sec. 2. GLOBAL COMMITMENT WAIVER AMENDMENT 1
53	53	(a) On or before September 1, 2025, the Secretary of Human Services shall 2
54	54	request approval from the Centers for Medicare and Medicaid Services to 3
55	55	amend Vermont’s Global Commitment to Health Section 1115 Demonstration 4
56	56	Waiver to make all Vermont residents eligible for hospital, medical, dental, 5
57	57	and prescription drug coverage equivalent to coverage in the Vermont 6
58	58	Medicaid state plan, regardless of income, as set forth in 33 V.S.A. § 1851. 7
59	59	(b) In the event that the Centers for Medicare and Medicaid Services does 8
60	60	not approve Vermont’s request for federal financial participation in providing 9
61	61	Medicaid-equivalent coverage to all Vermonters, regardless of income, the 10
62	62	coverage shall be funded with State-only dollars. 11
63	63	Sec. 3. AGENCY OF HUMAN SERVICES; COST ESTIMATES; 12
64	64	IMPLEMENTATION PLAN; REPORT 13
65	65	(a) The Agency of Human Services, in consultation with the Green 14
66	66	Mountain Care Board and the Department of Financial Regulation, shall: 15
67	67	(1) estimate the costs of providing hospital, medical, dental, and 16
68	68	prescription drug coverage equivalent to coverage in the Vermont Medicaid 17
69	69	state plan to all Vermont residents as set forth in 33 V.S.A. § 1851, including 18
70	70	the amount of State funds that would be required to support the program 19
71	71	through full implementation in 2033 both with and without federal Medicaid 20
72	72	dollars; 21 BILL AS INTRODUCED S.1
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77	77	(2) estimate the potential cost offsets in the health care system and 1
78	78	elsewhere in the economy as a result of all Vermont residents having access to 2
79	79	Medicaid-equivalent coverage; and 3
80	80	(3) develop and propose a detailed implementation plan for providing 4
81	81	Medicaid-equivalent coverage to all Vermont residents, beginning with 5
82	82	individuals up to 26 years of age in 2029 and continuing through full 6
83	83	implementation in 2033. 7
84	84	(b) On or before January 15, 2026, the Agency of Human Services shall 8
85	85	provide its cost and cost-offset estimates and implementation plan to the House 9
86	86	Committees on Health Care, on Appropriations, and on Ways and Means and 10
87	87	the Senate Committees on Health and Welfare, on Appropriations, and on 11
88	88	Finance. 12
89	89	Sec. 4. DEPARTMENT OF TAXES; PAYROLL TAX OPTIONS; REPORT 13
90	90	On or before January 15, 2027, the Department of Taxes, in consultation 14
91	91	with the Agency of Human Services, shall provide to the House Committees 15
92	92	on Health Care and on Ways and Means and the Senate Committees on Health 16
93	93	and Welfare and on Finance options for structuring a payroll tax to generate 17
94	94	the revenue necessary to support the State portion of the Medicaid and CHIP 18
95	95	expansion established in Sec. 1 of this act, both with and without federal 19
96	96	Medicaid dollars, based on the Agency’s cost estimates developed pursuant to 20
97	97	Sec. 3 of this act and any subsequent additional fiscal analysis. The 21 BILL AS INTRODUCED S.1
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101	101	VT LEG #378801 v.1
102	102	Department’s report shall set forth at least three payroll tax options and shall 1
103	103	include the Department’s recommendation for which option is the most 2
104	104	administratively feasible for employers, employees, and the State. 3
105	105	Sec. 5. EFFECTIVE DATES 4
106	106	(a) Sec. 1 (33 V.S.A. § 1851; Medicaid-equivalent coverage for all 5
107	107	Vermont residents) shall take effect on January 1, 2029. 6
108	108	(b) The remainder of this act shall take effect on passage. 7