House Health Care Committee reviews 2025 health laws, urges close oversight of hospital transformation

The House Health Care Committee on Jan. 6 reviewed an overview of the health laws passed last year and their near‑term implications for hospitals, insurers and consumers.

Jen Carpe of the Office of Legislative Counsel summarized multiple acts passed in 2025, telling the committee that early actions included permanently unmerging the individual and small‑group insurance markets and clarifying prior authorization and claim‑edit standards for out‑of‑state services. "Very early on in the session, was to permanently unmerge the individual and small group health insurance markets," Carpe said during the briefing.

Carpe described Act 68 as the center of this year’s transformation work. The act requires the Green Mountain Care Board to begin setting reference‑based prices — benchmarks tied to Medicare or other standards that represent maximum payments hospitals may accept — and to phase in global hospital budgets for non‑critical access hospitals by fiscal year 2027 and for all hospitals by fiscal year 2030. The law also prohibits balance billing and requires payers and providers to provide unredacted copies of executed or proposed contracts to regulators upon request.

The legislation creates new reporting and planning duties: an 18‑member health care delivery advisory committee, a statewide health care delivery strategic plan due Jan. 15, 2028, and a unified health data space to consider integrating clinical and claims data while protecting proprietary information. The act also appropriated roughly $2 million in incentive grants to encourage hospital transformation, and additional appropriations totaling about $3.4 million for board positions and transformational work.

Carpe noted other enacted measures of note: new licensure and Medicaid coverage direction for freestanding birth centers, an expansion of the Office of the Health Care Advocate’s powers (including access to rate‑review records), a hospital workplace‑violence security plan requirement, and a medical‑debt relief program funded at $1 million to acquire and retire qualifying old medical debts.

Committee members pressed for details about how reference‑based pricing and global budgets will be implemented and how smaller, critical access hospitals will be protected. Chair Rep. Alyssa Black said the work remains urgent: "The house was on fire," she said, arguing that oversight must continue to ensure hospitals remain viable while changes take hold.

The committee asked the Green Mountain Care Board and the Agency of Human Services for implementation updates and noted that many of the act’s deadlines for reporting and start dates fall over the next 12–36 months. Carpe and staff agreed to post slide materials and to follow up on effective dates and outstanding reports.

The committee concluded the session by scheduling follow‑up briefings from the Green Mountain Care Board and Agency of Human Services to review implementation progress and fiscal impacts.