Green Mountain Care Board tells appropriations committee Vermont health system faces acute financial strain

The Green Mountain Care Board told the Vermont House Appropriations Committee on Feb. 20, 2025, that the state’s health-care system is under acute financial strain as hospital prices, utilization and declining insurer reserves are driving rapid premium increases that threaten access and the solvency of some providers.

Board Chair Owen Foster, testifying with Executive Director Susan Barrett, said the board has reduced hospital budgets in recent years and reallocated money to primary care and other community services but that those steps may not be sufficient to stabilize the system. “We have a system wide view, and I would argue that all of our decisions are interconnected with the rest of the health care system,” Foster said. “We don't regulate many, many, many, many facets of the health care system,” he added, to clarify the board’s authorities.

The board told the committee that the state’s overall health-care spending is roughly $7 billion to $8 billion and that hospital budgets reviewed by the board total about $3.7 billion. Foster said the board enforced budget limits in recent years: in fiscal year 2023 the board’s enforcement reduced charges that would have been borne by commercial…