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By Michael Bielawski
On Thursday, lawmakers for the Senate Committee on Health and Welfare will take up a bill to increase the power of the Green Mountain Care Board (GMCB) to rein in spending at Vermont hospitals.
Some lawmakers say it’s necessary because a surge of illness that began in 2021 has unsettled health care systems’ financial stability.
The bill – H. 482, as passed by the House – and senators heard testimony on this subject in early April and will take it up again on Thursday. The bill would allow an “independent observer” working with the Board to ensure that hospital budgets operate within the financial commitments that health insurance companies make to their customers.
Sen. Martine Gulick, D-Chittenden Central, the committee vice chair, told VDC on Tuesday that the insurance company Blue Cross/Blue Shield has recently expressed that things are not going well budget-wise in Vermont.
“They have made the public aware of their financial situation,” Gulick said.
She said that the Department of Financial Regulation helps to determine whether a hospital is in adequate financial status. With this bill, if certain financial benchmarks aren’t met regarding an insurance provider’s capital for paying claims, the GMCB could intervene to ensure that all Vermonters’ health insurance claims are financed as promised.
The bill says if the Green Mountain Care Board working with the Commissioner of Financial Regulation determines that an insurance company faces “an acute and immediate threat to its solvency” based on its risk-based capital level falling to certain thresholds defined in statute (8 V.S.A. § 8304), then the Board may “order a reduction of the insurer’s reimbursement rates to one or more Vermont hospitals.”
It would also “permit the Board to reduce a hospital’s budget for the forthcoming fiscal year to account for the hospital’s budget overage in the previous fiscal year.”
Vermont gets suddenly sicker?
In written testimony submitted to the committee on April 10, Don George, President and CEO of Blue Cross and Blue Shield of Vermont, offered some concerning data on their operations in Vermont. First off, they report that more Vermonters are suddenly getting sick, and it started about three years ago.
“In 2024, claims were up more than 15% from the previous year as part of an unprecedented and sustained three-year cost surge,” the report states. The report does not speculate as to why there was a sudden uptick starting three years ago.
This new level of sickness has resulted in increased financial pressure on the insurer. They wrote to the committee, “As a result, in 2024, Blue Cross VT lost $65 million and concluded the year with an RBC [risk-based capital] ratio of 214%, which equates to $58 million in member reserves.”
Risk-based capital is a metric used to determine the minimum amount of money that an insurance company must have on hand to ensure that all customer claims are honored. The report notes that, currently, $30 million of those reserves are via an 8% interest loan to keep their operations viable in Vermont.
The report then states, “To put 2024 in perspective, consider that at the end of 2021 our RBC ratio was over 600% (the bottom of the range mandated by DFR), which equates to $136M in member reserves.”
The last concerning stat they share is “Our non-surplus note reserves dropped from $136 million to $28 million in just three years.”
More challenges ahead
The Vermont Association of Hospitals and Health Systems (VAHHS) put out a presser on Monday stating that, based on the testimony they observed, it does not appear that there are any other health insurance companies willing to take on the Green Mountain State.
“The Department of Financial Regulation underscored that no other insurance carrier is willing to take BCBSVT’s book of business,” the release states.
They further reported that not all interested parties are enthusiastic about everything so far in this legislation. VAHHS noted that Judi Fox, President and CEO of Rutland Regional Medical Center (RRMC), had “testified on how reducing reimbursement rates and appointing an independent observer could conflict with financial covenants, resulting in having debts called in.”
Fox also expressed interest in reference-based pricing as well as “providing the Green Mountain Care Board a tool to use under extenuating circumstances and urged the parties to get together to craft a solution,” according to VAHHS.
Contact them to weigh in
See all bills assigned to this committee here. Constituents may contact committee members (click link on name for bio, party affiliation, etc.) with comments, questions, and information at the following email addresses:
Senate Healthcare
Sen. Virginia “Ginny” Lyons, Williston, Chair, vlyons@leg.state.vt.us
Sen. Martine Larocque Gulick, Vice Chair, Burlington, mgulick@leg.state.vt.us
Sen. Ann Cummings, Montpelier, acummings@leg.state.vt.us
Sen. Larry Hart, Topsham, lhart@leg.state.vt.us
Sen. Samuel Douglass, Clerk, sdouglass@leg.state.vt.us
All committee transcripts are available at http://www.goldendomevt.com. The Committee meeting video is available at the committee’s YouTube channel. The committee meets in the morning in Room 17.
The author is a writer for the Vermont Daily Chronicle
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Categories: Health Care, Legislation, State Government
Hello! As with all of Vermont’s centralized government control, be it education, healthcare, or government itself, the trend continues. Spend more – get less.
When will we ever learn?
Raise all of Vermont’s land values for more taxes and problem solved, simple solution as per Liberal thinking
Where is Dr Baffled when you need he/him?!
Dr. Baffled is sharing Patrick Soon Shiong’s luxury box with Dr. Obvious.
Well Vermont had one if not the highest covid vaccination rate in the country. Everyone moved here for that reason. Well guess what. Big pharma made big bucks off of Vermonters and the out of staters that moved here to be safe🤣🤣🤣and now they’re getting more wealth from the vaccinated. 🤔
That was my first thought too. Is it any wonder Vermonter’s are getting sicker, when it was the most C19-injected state in the USA? So many Vermonter’s believed the lies Fauci told us, that these Experimental mRNA Gene Therapy C19-injections we’re “Safe & Effective” … They were neither.
The list of potential adverse reactions that Pfizer wanted to keep hidden for 75 years is 80 pages long. The spike protein continues to replicate (because it’s a ‘gene-therapy’ ~ not a genuine ‘vaccine’) and because it was delivered in a lipid-package, it gets into every part of our body, including the heart, brain, kidneys, reproductive organs (explaining the decrease in birthrates), nervous system, etc.
And then to add insult to injury, we have Senator Bernie Sanders in denial about the dangers of the C19 “Vaccine” by blaming the rise in illness as being caused by “Long Covid” (i.e., SARS-CoV-2)~ hence, his proposed “Long Covid Moonshot Bill”. There is no science to back this assumption. But there are mountains of evidence the C19 shots harmed, and even killed millions. If this wasn’t true, then why are several countries seeking to sue Anthony Fauci for the millions killed.
And, why would Sanders assume “Long Covid” is to blame, when C19 had a 99% survival rate, unless one was elderly, diabetic, obese, or immune-compromized ? By Sanders blaming the increase in sickness, deaths & disabilities on “Long Covid”, all this does is deny Big Pharma’s role in harming the victims. And, worse, it protects the CDC & Legalized Drug Cartels who are likely to try this propaganda campaign again if they are not held accountable.
The CDC pushed mandating this toxic experiment on healthy individuals with 0.1% risk of death. The mandates were Illegal; they violated the Nuremberg Code of Ethics. And, I find it infuriating the perpetrators; Pfizer, Moderna, AstraZeneca & Jansen aren’t paying for the rise in healthcare costs & damages to people’s health, while they profited in the billions.
The rise in strokes, heart failure, emboli, sudden unexplained deaths, myocarditis, TurboCancers, sepsis, pneumonia, autoimmune diseases, and VAIDS (Vaccine -induced AID’s) is not from “Long Covid” Senator Sanders. It’s from the C19-injections that are still on the CDC’s Pediatric list of recommended ‘vaccines’ for 6 – 9 month olds (who are at zero risk of getting C19) and they are scheduled to get 3 of these shots by 9 months of age! Make it make sense. Profits are the ONLY Healthcare Goals this country has; aka “Sick Care.”
When are y’all going to connect the dots as to why there is an increased level of sickness? It’s so obvious it’s ridiculous!
Used to be hospital priorities were to care for the ill, not the budget, and not over enriching the mugs at the top. Seems GMCB legislates more for administrators than they do the customer or providers. Used to be patient care wasn’t mandated by care boards and sloppy legislators. Fixate on greed at the top and keep cutting services at the bottom. A big business model of course with no compassion for the ill. Hurray for the money hungry.
From the article: “In 2024, claims were up more than 15% from the previous year as part of an unprecedented and sustained three-year cost surge,” the report states. The report does not speculate as to why there was a sudden uptick starting three years ago.”
It seems to me that answering the exceptionally important question of WHY “claims” are up 15% from the previous year should be priority #1.
Are people really “sicker” and, if so, why?
By analogy in the realm of public school education, results from both national (NAEP) and state (VTCAP) standardized testing shows 30-60% of public school students statewide exhibit significant levels of learning deficiencies in math, science, and reading.
Why is public school education in Vermont failing so many students?
The extraordinary level of learning deficiencies is occurring in spite of the fact that Vermont has the second highest spending per pupil of all 50 States, spending more than 2x as much as 16 other states.
One would think that spending massive amounts of of taxpayer money on education, while generating extraordinarily high levels of student learning deficiencies, would inspire the Legislature to ask WHY this unsustainable economic disconnect is occurring.
The Legislature appears committed to NOT asking that question. Getting more money to union members that are involved in pubic school education appears to be the primary focus of the Democrats and Progressives in the Legislature who remain in a majority position.
Thank you for this story Michael.
It sure appears like corruption when No One sitting on the health committees in Vermont’s House or Senate are asking (actually, these legislators should be demanding to know) why there is a sudden 15% uptick in claims. Republicans and Democrats both – you are either incompetent fools or paid off agents of the medical industrial complex. Which is it?
Will the independent observer have a high paying salary with great benefits? The bill says the GMCB “could intervene” and “may order a reductions”. But will the GMCB do so. You have to watch words like could and may. The article doesn’t say the BCBS wants another 15%-20% increase again this year. I believe they will make the request in May. The GMCB will most likely grant the request because too many Vermonters will lose their health insurance if BCBS fails. I used to have an insurance company that rewarded me with lower rates because I made healthy choices but our Vt Legislature made a law that all insurance companies had to go to community rating and this company left the state and BCBS was on its way to being a company too big to fail. Well it is failing now and obviously our legislature doesn’t know how to fix it.
“Some lawmakers say it’s necessary because a surge of illness that began in 2021 has unsettled health care systems’ financial stability.”
Correlation is not proof of causation, that said the correlation to the timing of increased illnesses and the heavy rollout of the jab IS the place to start. If anyone objectively looks at the mountains of evidence already existing it’s pretty obvious. As to “safe and effective” it totally was…safe for big pharma to commit murder and effectively makes TONS of money in the process.
Baby boomers all all across the country are getting older. More visits to Dr, hospitals. Duh
Are people sicker due to slow, methodical poisoning? A calculated and designed business model of mind controlled consumers from crib to grave? Funny how healthcare has morphed into sicklycare. Perhaps all the thievery and deeds done dirty is meeting it’s justified diagnostic malignant terminal radiated chemically lab-induced lab grown bioweapon end game. No honor among thieves, frauds, and tricksters.
There was predictions that it would take three to five years for the most damage from the COVID KILL SHOT to come about.