Senate Health and Welfare holds Medicaid 101 briefing on Global Commitment waiver and funding

The Senate Health and Welfare committee on Thursday, January 16 heard a Medicaid 101 briefing from Nolan Langwell of the Joint Fiscal Office and Ashley Ferlina, director of Medicaid policy for the Agency of Human Services, reviewing how Vermont’s Medicaid program is structured, funded and authorized by the state’s 1115 waiver known as the Global Commitment to Health.

The briefing emphasized the program’s scale and budgetary weight: presenters said roughly 197,000 Vermonters have received Medicaid services and that Medicaid accounted for about $2.3 billion in total expenditures in fiscal year 2024. Nolan Langwell noted, “Some of the data is still outdated,” and the presenters said several slides relied on the most recent available figures, some of which are from 2021.

The committee was shown how federal matching funds drive Medicaid financing in Vermont. Ashley Ferlina explained that “1115 waivers allow the explicit waiving of certain provisions of the Social Security Act,” and that Vermont’s Global Commitment waiver — in place since 2005 and set to run through the end of 2027 — lets the state receive federal participation for…