A collection of resources on health system performance in Vermont.
Vermont Performance Data
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Access to Health Care
Vermont Policy Information
Traditionally expanded Medicaid (31 states + DC)
State-based marketplace (17 plus DC)
The state is responsible for all marketplace functions, including health plan management, consumer assistance, eligibility and enrollment, financing, and marketing and outreach. The state manages its own marketplace website where individuals can enroll in coverage.
Has not established a public coverage option
Extended 2022 open enrollment
Extended 2022 open enrollment period through Jan. 15, 2022.
Did not extend the open enrollment period for 2018 or 2019 coverage. In response to the COVID-19 pandemic, enrollment for 2020 was reopened from Mar. 20, 2020 through Aug. 14, 2020 and enrollment for 2021 was reopened from Feb. 16, 2021 to October 1, 2021.**
Provides premium and cost-sharing subsidies
State provides premium and cost-sharing subsidies for marketplace enrollees with incomes up to 300% FPL (subsidies are in addition to federal premium tax credits and cost-sharing assistance)
Sets stricter limits on the sale of short-term coverage than the federal government
Does not prohibit underwritten short-term coverage*
Limits the initial contract duration of underwritten short-term coverage to 3 months**
Underwritten short-term coverage cannot exceed 3 months in a 12-month period***
Prohibits non-compliant transitional policies
Does not permit insurers to sell non-compliant transitional policies in the individual market
Does not exempt other coverage from insurance rules
Does not exempt other coverage products from federal and state rules for individual market insurance*
One or more rules to promote marketplace competition
Established the following to promote a competitive ACA marketplace:
– Merged its individual and small-group markets to create a broader risk pool
– In 2014 and 2015, Vermont required all individual market coverage to be sold through the ACA marketplace. Beginning in 2016, insurers under contract with the marketplace were permitted to enroll individuals directly. In response to temporary enhancements to federal premium subsidies for individual marketplace enrollees, Vermont separated its individual and small-group markets for 2022, only.
Requires standardized cost-sharing plan design
Requires participating individual market insurers to offer plans with standardized cost-sharing designs
Does not require all individual market plans to be standardized