[{"_1":2,"_99":-5,"_100":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},"mediaId",6079914,"mediaKeyId","2953447-26ded7b657e513bdd5790448f676766f","parentId",2953447,"title","Advocates press committee to take up H.302 next year to require insurance coverage for fertility and preservation","audioSeconds",5805,"startMs",5812000,"endMs",6502,"viewUrl","/Search/View?dp=1&key=2953447-26ded7b657e513bdd5790448f676766f&start=5812&end=6","thumbnailUrl","https://assets.pipeline.soar.com/2953447-26ded7b657e513bdd5790448f676766f/thumbnail_5812000.jpg","articleUrl","/articles/6079914/Vermont/Advocates-press-committee-to-take-up-H302-next-year-to-require-insurance-coverage-for-fertility-and-preservation","mediaUrl","https://secure.pipeline.soar.com/6079914-64a45fb384a7ac91c4c0d3f5a4d0745a/orig.mp4?Expires=1771150570&Signature=Xippf4k2OCVKt3RWgp63CJ3qdLVSgkM1eGCGXdvLlpxvpDA3KEMg59CA36Nmb-8mBtL0DvtulD8UOdcPLLckn50773fizUTJQSKYtAI5SiLj4uRsji3DJjORkJvCciTKKrTaGLk47zlpYOc2TvPwTyKC67FX78xl~283Vb18i6CYS6-YS9TkFLRxPi4B2nfREIJL71PnPaGdc-zUmDi9P9ow6dQuA4ShCsd2uODAYhge8XHRvmTPZ1FOJ3mAw6OtGAvkx1Rb1gJXq0Jxfh8rXmrpyYCi6uTHtDkLft2IYXkwd7c1ENE2QUWwKRbNVIqz0oHEkNIaLc-7DtVj6U6mYg__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-04-10T23:53:05.04Z","article","Advocates, medical providers and people with lived experience asked the Senate Health and Welfare Committee April 10 to consider House Bill H.302 next year, a proposal that would require private and public insurance to cover certain fertility diagnostic tests, treatments (including in vitro fertilization) and medically necessary fertility preservation.

Kate Walden LeBlanc, executive director of All Paths Family Building, said the organization is urging lawmakers to take H.302 up next year and stressed inclusion, noting Vermont is the last Northeastern state without comprehensive fertility-insurance legislation. “It is estimated that 1 in every 6 people will go through infertility,” she said, and she described the bill’s coverage as limited by medical guidance while still allowing flexibility for families who need multiple cycles.

Representatives from Northeastern Reproductive Medicine in Colchester and patient advocates testified that fertility preservation is frequently medically necessary for patients facing cancer and other treatments that can impair fertility. Several speakers said state action would reduce a key financial barrier and help retain younger Vermonters who otherwise might move to neighboring states that already guarantee fertility coverage.

Witnesses described specific guardrails in the draft bill — limits tied to medical guidance and allowances for medically necessary preservation — and urged lawmakers to craft inclusive language for LGBTQIA+ families and people needing genetic screening. Committee members thanked the witnesses and asked advocates and providers to return next session with cost and implementation details; H.302 was not advanced during the April 10 hearing.

Advocates said they will continue outreach and urged the committee to schedule the bill for substantive consideration in the next legislative session.","mediaType","Video","parentTitle","Senate Health and Welfare - 2025-04-10- 10:15 AM","oneSentenceSummary","Advocates, medical providers and people with lived experience asked the Senate Health and Welfare Committee April 10 to consider House Bill H.302 next year, a proposal that would require private and public insurance to cover certain fertility diagnostic tests, treatments (including in vitro fertilization) and medically necessary fertility preservation.","taxTitle","Health & Welfare, SENATE, Committees, Legislative , Vermont","taxId",38585,"location","Vermont","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6079919,"Pharma and insurers clash over H.266 340B changes; Blue Cross urges transparency as drug markup in Vermont hospitals alarms payers",1059,4581000,5640000,"/Search/View?dp=1&key=2953447-26ded7b657e513bdd5790448f676766f&start=4581&end=5640","https://assets.pipeline.soar.com/2953447-26ded7b657e513bdd5790448f676766f/thumbnail_4581000.jpg","/articles/6079919/Vermont/Pharma-and-insurers-clash-over-H266-340B-changes-Blue-Cross-urges-transparency-as-drug-markup-in-Vermont-hospitals-alarms-payers","https://secure.pipeline.soar.com/6079919-cfe240a37be75cd7b03a8d71efe05640/orig.mp4?Expires=1771150570&Signature=KYfPBqnwHUGcfMlh2te2KGtUPOo~gwfajMixCXx22tCaPLSE59pdWlJP~D8TTQ~3HX3GvS7owVqVDTI0d36QknbmkpCZNs9oxG9v~57UdbF1mprQfVRQD6joHAuNOkmkaTdNcrNb4mVnIyxhBENMBHWhjBLTzYafHB1IjQuMgzz98-bS~AHeLoe-K6rvGZOCQYJfhSI0Rj6QzJzNXJjd~z9FnMoqw0xkMsl54wskZg2f~CdWqKugMzHWatRrPD0e69tO4qElv1S8DlG~IGb6zcvb5YhtQeklSGk4bRsdBRrDPFh1rKWvoWyJv2Tmm9gxp-ghyD9OUiq85pLgfY9-8w__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Health and Welfare Committee heard competing testimony April 10 on H.266, a bill that would alter 340B contract-pharmacy arrangements and add state-level protections and transparency. Witnesses sharply disagreed about whether the proposed changes would protect safety-net providers or lock in a model that benefits middlemen.

Morgan Halloran, director for state policy at Pharmaceutical Research and Manufacturers of America (PhRMA), testified that Section 1 of H.266 would “codify a broken model of the 340B program,” saying contract pharmacy arrangements have been increasingly dominated by vertically integrated pharmacy benefit managers (PBMs). Halloran cited studies and industry data saying 69 percent of contract-pharmacy arrangements involve three PBMs and that the program’s expansion has reduced manufacturer rebates to insurers, potentially increasing premiums.

Blue Cross and Blue Shield of Vermont urged the committee to add more transparency. A Blue Cross representative told lawmakers the insurer lost about $12,600,000 in manufacturer rebates last year because drugs were shifted through 340B arrangements, and that commercial payers often pay markedly higher prices for drugs administered in hospitals than through PBM channels. Blue Cross cited a RAND analysis showing Vermont hospital commercial drug prices well above the national average and presented internal data indicating Vermont hospital prices for certain infused drugs can exceed average sales price by multiples, with substantial concentration at the University of Vermont Health Network.

PhRMA witnesses warned that the bill’s limits on manufacturers’ access to claims-level data and the creation of a private right of action against manufacturers could undermine federally authorized audit rights and program integrity. PhRMA urged the Legislature to require a fact-finding and transparency effort—similar to work done in Minnesota and North Carolina—before enshrining unlimited contract pharmacy arrangements in state law.

Blue Cross and other payers called for a state-level transparency or advisory process so the Legislature can see where 340B revenue and contract-pharmacy flows are occurring, how much revenue is leaving the state, and what impact the current arrangements have on commercial rebates and premiums.

Committee members sought further data and said they may request more detailed analyses and options for targeted transparency language. No final vote was taken on H.266; sponsors and opponents agreed more fact-finding and narrower transparency language could be a path forward.","The Senate Health and Welfare Committee heard competing testimony April 10 on H.266, a bill that would alter 340B contract-pharmacy arrangements and add state-level protections and transparency.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6079924,"Senate committee hears divided testimony on H.482 to let Green Mountain Care Board adjust hospital rates to shore up Blue Cross Vermont",4344,112000,4456000,"/Search/View?dp=1&key=2953447-26ded7b657e513bdd5790448f676766f&start=112&end=4456","https://assets.pipeline.soar.com/2953447-26ded7b657e513bdd5790448f676766f/thumbnail_112000.jpg","/articles/6079924/Vermont/Senate-committee-hears-divided-testimony-on-H482-to-let-Green-Mountain-Care-Board-adjust-hospital-rates-to-shore-up-Blue-Cross-Vermont","https://secure.pipeline.soar.com/6079924-734159e9f97a99dfc2411959eaadc28c/orig.mp4?Expires=1771150570&Signature=LWc2YtcvfchM25lcte2kI3FGsr~m3d-97IsTx84D2QBeo~xLiIcHtii9XaLJh0dAMZe0COlDQbZRfzL8vcJMhO5DO7l9CA-ZGJISFAShqkfxM7YgRkye9PzCl5wmVK3rwxTjLcXUdpYL-7ST0CNEwXhU3YVVEh7a3bxFOh2G-U4On~gVsfuf8k~C1uGgfzRsx-x4bFGCWpwr7lJSZdjE7X0WNkUlisMo4kn7dTAlwdW5IV9Sc39pzZoAQtlD~OdUf9-ijFDq3puCBsm4ols1TlzRMUWluGwFbMx6SPqaWhmnjcNGM2oRlwYGiSTN4Mk5Xos3mD3jZ93As3u4UU6HAA__&Key-Pair-Id=KUT5TJCACFTXG","Senate Health and Welfare Committee members heard hours of testimony April 10 on House Bill H.482, which would permit the Green Mountain Care Board, in consultation with the Department of Financial Regulation (DFR), to adjust hospital reimbursement rates for a domestic health insurer facing an acute solvency threat.

DFR Deputy Commissioner of Insurance Emily Brown told the committee “DFR is the primary and sole financial regulator of insurance companies who are domesticated in Vermont.” She said the bill’s trigger is a risk-based capital (RBC) ratio at or below 150 percent and that the change would target hospitals that have “more than 135 days cash on hand and meet other financial metrics.” The intent, she said, is to preserve continuity of coverage if Blue Cross Blue Shield of Vermont (BCBSVT) faces an immediate solvency risk.

The proposal drew a direct appeal from Don George, president and CEO of Blue Cross Blue Shield of Vermont. George described a multi-year surge in claim costs that left BCBSVT with a year-end RBC of about 214 percent for 2024 and a reported operating loss he said was about $65,000,000 last year. He urged the committee to adopt the bill as an emergency tool, saying, “This is a Vermont solution,” and arguing it could prevent far costlier outcomes for members and providers.

Hospital trade groups and individual hospital leaders opposed or warned against the bill’s current language. Mike DelTreco, president and CEO of the Vermont Association of Hospitals and Health Systems, said the measure could destabilize hospital finances by permitting rate reductions for hospitals that have relied on days-of-cash covenants with lenders. Rutland Regional Medical Center President and CEO Judy Fox told the committee that her hospital once negotiated a covenant that required maintaining 150 days of cash on hand and said the bill’s 135-day threshold could put some hospitals below lender covenants; she added that Rutland lost 18 days of cash on hand in a matter of days recently.

Hospital witnesses also criticized a provision that would allow appointment of an “independent observer” to review hospital data. They said lenders already have mechanisms — including the ability to appoint a financial facilitator under bond covenants — and that adding a separate observer could be costly, duplicative and adversarial.

Supporters and regulators stressed narrow triggers and limited scope. Brown and George emphasized that the authority would be invoked only in an acute solvency emergency for a domestic health insurer and would target financially healthy hospitals (as defined by the bill’s metrics) to shift reimbursement temporarily and specifically to the insurer at risk. George described recent liquidity steps taken by BCBSVT, including a surplus note and cost-savings measures, and said the bill would be a last-resort tool to preserve weekly claim payments and continuity of care.

Committee members acknowledged the competing risks and asked regulators and stakeholders to craft guardrails to reduce unintended impacts on hospitals. Senator Ginny Lyons, chair of the committee, urged further language work to prevent adversarial processes and to preserve hospital stability while protecting insured Vermonters.

The committee did not take a final vote on H.482. Lawmakers said they will continue to work with DFR, the Green Mountain Care Board, Blue Cross Blue Shield of Vermont and hospital leaders to refine the bill’s thresholds, independent-observer language and other guardrails before further action.","Senate Health and Welfare Committee members heard hours of testimony April 10 on House Bill H.482, which would permit the Green Mountain Care Board, in consultation with the Department of Financial Regulation (DFR), to adjust hospital reimbursement rates for a domestic health insurer facing an acute solvency threat.","actionData","errors"]

Article not found

Advocates press committee to take up H.302 next year to require insurance coverage for fertility and preservation

Pharma and insurers clash over H.266 340B changes; Blue Cross urges transparency as drug markup in Vermont hospitals alarms payers

Senate committee hears divided testimony on H.482 to let Green Mountain Care Board adjust hospital rates to shore up Blue Cross Vermont