House amends H.611 to delay Medicaid doula coverage and approves technical DVHA changes

Representative Powers, speaking for the Health Care Committee, presented H.611 as a technical, housekeeping bill for the Department of Vermont Health Access (DVHA) that includes a mix of administrative clarifications and short-term policy delays. "This will allow the Agency of Human Services an additional year to best determine how to seek the Centers for Medicare & Medicaid Services approval," Powers said, describing the compromise to delay full implementation of Medicaid coverage for doula services.

The bill would: repeal a requirement that DVHA publish annual lists of prescription drugs with large recent price increases and the timing language about 340B pricing (a provision currently in litigation); align Medicaid and Exchange Advisory Committee membership with federal beneficiary-advisory requirements; remove small-group market references from reflective health benefit plan language; change minimum/term language for the Technical Utilization Review Board; eliminate use of federal modified adjusted gross income (MAGI) in VPharm eligibility calculations; increase the amount a Medicaid beneficiary may hold in an irrevocable prepaid funeral account from $10,000 to $15,000; and delay DVHA’s deadline to seek federal approval for Medicaid doula coverage from 07/01/2026 to 07/01/2027. The act’s effective date was also adjusted in the bill text.

Powers walked the chamber through the bill’s sections and the committee’s outreach, noting testimony from the director of Medicaid Policy, Office of Professional Regulation, Vermont Legal Aid, the Office of the Health Care Advocate, provider groups and other stakeholders. Representative Iacoboni, speaking for Appropriations, told members the committee reviewed the bill with Legislative Council and the Joint Fiscal Office and "our determination is there are no fiscal impacts to our state budget, and we recommend your support of this bill." Iacoboni also corrected a typographical error in the printed calendar: the Appropriations committee vote was 8-0-3 (not 9-0-2 as printed).

After debate and committee reports, the House voted by voice to amend H.611 as recommended by the Health Care Committee and then voted to read the bill a third time; the Presiding Officer ordered third reading.

Why it matters: H.611 affects multiple administrative processes at DVHA and pauses a timetable for seeking federal approval to cover doula services under Medicaid. The delay gives state agencies more time to design a CMS submission they say will better reflect how doula services are delivered in Vermont. Provisions touching pharmacy pricing and VPharm eligibility could affect patients and providers, although committees reported no immediate state fiscal impact.

What’s next: Third reading has been ordered for H.611. If the House passes the bill on third reading, the act’s effective dates and the delayed deadlines will govern DVHA rulemaking and implementation timelines.