Vermont officials outline how federal HR 1 will reshape Medicaid eligibility, payments and outreach

Vermont health and human services officials told the Senate Health & Welfare Committee on Jan. 9 that a federal budget reconciliation law known in the briefing as HR 1 will bring immediate and longer-term changes to Medicaid and marketplace programs that the state must implement over the next three to five years.

The presentation by Jill Naza Olson, Medicaid and Health Systems Director at the Vermont Agency of Human Services, Addie Stremelow, Deputy Commissioner at the Department of Vermont Health Access, and Ashley Berliner, Director of Medicaid Policy, focused on four major areas: a one-year federal prohibition on Medicaid reimbursements to Planned Parenthood; limits and phased reductions to hospital provider taxes; caps and reductions for state-directed payments; and new cost-sharing, redetermination and work-requirement rules affecting the Medicaid expansion population.

Officials said the Planned Parenthood provision took effect on 07/04/2025 and bars Medicaid reimbursement to Planned Parenthood-like entities through 07/03/2026. Ashley Berliner said the state expects about $1.1 million in gross Planned Parenthood Medicaid claims for 2025–26, representing roughly $600,000 in lost federal match, and that "Planned Parenthood Medicaid…