What the Health?

From medical debt to rising drug costs, we are feeling the strain of a healthcare system that’s too expensive, too complex, and too fragile. It is not getting better under this federal administration, folks. The good news is my committee led on major legislation this year to confront our healthcare crisis. We have passed legislation that will offer relief to patients in debt, curb grossly excessive prescription drug markups, bring exciting, holistic access to women’s health services, and put safeguards in place if a health insurer (like BCBS) fails—which nearly happened. Together, these measures are designed to make care more stable, affordable, fair, and sustainable for all people across the state. They also aim to strengthen accountability and transparency, giving you greater control over your healthcare choices.

Cap on prescription drug prices, and lower insurance premiums

Act 55 is remarkable and I’m going to tell you why you should be excited about it. As I said on the House floor when I presented this bill,

Last year at UVM Medical Center 40% of all commercial insurance billings were for outpatient drugs (Insulin, anti-diabetics, cancer meds, asthma, cholesterol, blood pressure, mental health, allergy meds). Right now through health insurance premiums Vermont residents pay 90% of what the hospital charges for outpatient drugs. These charges can change week to week for the same drug, making it almost impossible for patients, employers, and small businesses to budget their health care costs.

But the real problem? The price of a single drug doesn’t just reflect its cost. It’s all mixed up in the hospital’s finances. Hospitals mark up some items, sometimes as high as 600%, or even 5,000% for certain drugs—often life-saving drugs like those used for cancer and Crohn’s disease—to make up for shortfalls in other areas. These are drugs that patients can’t shop around for; there’s no competition, no market forces—just a Vermonter, sitting in a chair, getting a drug they can’t refuse, at a price they never chose.

We needed this. The new law sets a ceiling on what hospitals can charge for certain outpatient prescription drugs administered in an outpatient or office setting. Hospitals (except critical access hospitals) are now prohibited from billing insurers more than 120 percent of a drug’s average sales price. It also strengthens protections for the federal 340B program, which lowers outpatient drug costs for vulnerable populations, guarding against discriminatory practices or restrictions from drug manufacturers. The Vermont Association of Hospitals and Health Systems has supported this as critical to protecting affordable access for those who rely on the program. Thanks to this law, those of you on private insurance will see savings on your insurance premiums of around 4% since no hospital in the state can charge your insurance $6,000 for a drug they buy at $60.

Certification and Medicaid coverage for doulas

Act 50 creates a voluntary state certification process for community-based perinatal doulas—trained, non-medical professionals who provide educational, emotional, and physical support to pregnant women and their families. Under this law, Vermont Medicaid must cover services provided by certified doulas during pregnancy, labor, delivery, and postpartum.

Beyond expanding access to culturally competent and community-based birth support—especially in areas where maternity care options are limited—this measure is also an important step toward addressing persistent racial disparities in maternal health outcomes. Women of color, Black women in particular, face significantly higher risks during pregnancy and childbirth even when controlling for income and education. By recognizing and reimbursing doula care, Act 50 supports more equitable, patient-centered maternity care, affirms freedom of choice in birth support, and invests in approaches proven to improve safety, dignity, and health outcomes for all families.

As a mom of two (out of state and out of hospital) doula-assisted births, I am grateful all other women now have this option. Thank you to our own Senator Martine Larocque-Gulick who so thoughtfully and inclusively led this bill in the Senate.

Medical debt relief and credit report protections

Act 21 directs $1 million to a nonprofit partner to purchase and forgive up to $100 million in medical debt for eligible Vermont residents. People qualify if their household income is at or below 400 percent of the federal poverty level, or if their medical debt amounts to at least 5 percent of household income. The law also prohibits credit reporting agencies from collecting or sharing information about medical debt and bars healthcare providers from reporting it. The intent is to give residents a fairer chance at financial recovery while ensuring medical bills don’t create long-term damage to credit histories.

Where did this great idea come from, you might ask? Our State Treasurer (and fellow Winooski resident) brought a compelling proposal to the legislature and we were off and running. Thank Mike next time you see him at Four Quarters or Onion City.

Health insurer fallback plan

Act 49 establishes a contingency process for domestic health insurers facing “immediate” insolvency—when an insurer can no longer meet its financial obligations, such as paying claims. In these cases, the Green Mountain Care Board may temporarily lower the insurer’s reimbursement rates to one or more Vermont hospitals that meet specific fiscal criteria. The board is limited to reducing rates only as much as necessary to address the insurer’s causes of insolvency, ensuring that patients can maintain coverage and providers remain paid during a financial crisis.

These laws are part of my ongoing effort to make Vermont’s healthcare system more equitable, affordable, and accessible. We all know that is an uphill battle, especially in this new federal landscape with resources rescinded that undermine efficacy of life-saving programs, and human rights violations on people of color and our LGBTQ loved ones and leaders, but this is the exact fight I asked to be in for you. I am honored every moment of it and motivated to fight harder.