By Guy Page
Gov. Phil Scott’s reelection campaign is challenging Democratic opponent Amanda Janoo’s proposal to provide universal primary health care in Vermont, arguing that the plan could cost hundreds of millions of dollars more than the revenue Janoo has proposed to raise.
In a press statement issued October 12 following an October 8 VTDigger report, Scott campaign spokesperson Emma Shouldice questioned whether Janoo has adequately explained how the program would be funded or how health care services would be delivered.
“It’s one thing to put a policy proposal on the table,” Shouldice said. “But anyone running for office has a responsibility to be straight with Vermonters about how much that policy would cost and how it would work.”
Janoo has proposed making primary care available to all Vermonters without charges at the point of service, financed at least in part through higher taxes on upper-income households.
The Scott campaign cited a 2016 report prepared during Democratic Gov. Peter Shumlin’s administration that estimated the annual cost of universal primary care at $294.1 million to $316.6 million.
Adjusting those figures for medical inflation, the Scott campaign estimates the cost today would range from $580 million to $611 million annually.
By comparison, the campaign said proposed taxes on higher-income Vermonters would generate between $114 million and $344 million annually, potentially leaving a funding gap of hundreds of millions of dollars.
Those figures are the Scott campaign’s estimates, not an independently verified fiscal analysis of Janoo’s current proposal.
How the proposed income tax increases would work
The Fair Share for Vermont Campaign, which advocates higher taxes on wealthy Vermonters, has outlined three options for raising additional state revenue. The group argues that Vermont could recover some of the federal tax reductions received by high-income households under the federal tax and budget legislation enacted in July 2025.
The first option would impose a 3% surcharge on personal income exceeding $500,000 annually. Fair Share estimates that the tax, affecting roughly the top 1% of Vermont income earners, would raise $114 million per year.
The second option, described as a federal tax cut “clawback,” would impose a 2% surcharge on personal income exceeding $250,000 and a 5% surcharge on income exceeding $500,000. Fair Share estimates this would raise $230 million annually, recovering approximately all of the federal tax reductions received by the wealthiest 1% of Vermont earners and 10% of those received by the next 4%.
The third option combines the original proposal with the federal tax clawback. It would impose a 2% surcharge on personal income exceeding $250,000 and an 8% surcharge on income exceeding $500,000. Fair Share estimates that this approach would raise $344 million annually.
The surcharges would apply to income above the specified thresholds, not to a taxpayer’s entire income. For example, under the second option, a household with $600,000 in taxable income would pay an additional $7,000 on the income between $250,000 and $500,000 and an additional $5,000 on the income above $500,000, assuming the two surcharge rates apply to separate income brackets. That would total $12,000 in additional annual state income taxes.
Fair Share argues that the added revenue could help Vermont offset federal funding reductions while supporting state services and new investments.
The group’s three proposals are alternatives, not three separate taxes that would all be imposed. Nor does their estimated revenue necessarily represent money dedicated solely to universal primary care.
Even the highest-revenue option, at $344 million annually, would fall $236 million to $267 million short of the Scott campaign’s estimated annual cost of universal primary care, assuming all the revenue went toward that program and no other funding or savings were available.
Competing approaches to health care
According to VTDigger’s October 8 report, Janoo has acknowledged that her cost and revenue calculations remain preliminary and that more detailed analysis would be needed to determine staffing, salaries and other expenses.
Janoo has also suggested that broader access to preventive care could save Vermont as much as $300 million annually by reducing emergency room visits and hospital admissions. That estimate remains preliminary, and the amount of savings that could be realized has not been established.
The Scott campaign argues that such projections do not provide a firm basis for financing a new statewide program.
“Vermonters need real solutions to lower healthcare costs, not half-baked, ideological talking points,” Shouldice said.
Scott has advocated changes to Vermont’s health insurance market, including greater flexibility in insurance plan design and expanded consumer choice. His campaign argues that insurance options available in neighboring New Hampshire demonstrate the potential for lower premiums.
The campaign cited an example of annual family insurance premiums exceeding $26,000 in Vermont, compared with approximately $11,000 in New Hampshire. The statement did not provide enough detail to establish whether the plans have comparable benefits, deductibles and eligibility requirements.
The debate comes as Vermont lawmakers are already studying universal primary care. Legislation signed by Scott in June directs state officials to examine options for establishing such a program, with a report due to the Legislature in January 2027.
Supporters of universal primary care say eliminating out-of-pocket charges for basic medical services could improve access, encourage preventive treatment and reduce some long-term health costs. Critics question whether those savings would be large enough to offset the expense of a publicly funded system.