Vermont Highlights
5 Vermont's 2019 Rank
To learn more about state rank, visit our 2019 Scorecard on State Health System Performance.
Source: Commonwealth Fund 2019
Key Demographics
| Vermont | US Average | |
|---|---|---|
| Total Population | 617,936 | 320,842,721 |
| Median Household Income | $60,671 | $65,727 |
| Below 200% of Federal Poverty Level (FPL) | 29% | 31% |
| % White Race, Non-Hispanic | 93% | 61% |
| % Black Race, Non-Hispanic | 1% | 12% |
| % Other Race, Non-Hispanic | 4% | 9% |
| % Hispanic Ethnicity | 2% | 18% |
Key Health Policies in Vermont
Vermont Performance Data
Vermont Policy Data
| Policy | Source | Action Taken | Notes | Info |
|---|---|---|---|---|
| <p>Medicaid expansion status</p> | The Commonwealth Fund | 1 | Traditionally expanded Medicaid | - |
| <p>Medicaid work requirement status</p> | The Commonwealth Fund | 0 | No work requirement | - |
| <p>Affordable Care Act health insurance marketplace type</p> | Center on Health Insurance Reforms, Georgetown University Health Policy Institute | 3 | State-based marketplace | The state is responsible for all marketplace functions, including health plan management, consumer assistance, eligibility and enrollment, financing, and marketing and outreach. The state manages its own marketplace website where individuals can enroll in coverage. |
| State-operated individual market reinsurance programs supported by federal funding from an ACA innovation waiver | J. Giovannelli, K. Lucia, and S. Corlette, "To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States." The Commonwealth Fund | 0 | State does not operate a reinsurance program | Has not applied for a future waiver |
| State requirements for individuals to maintain adequate health coverage (individual mandates) | J. Giovannelli, K. Lucia, and S. Corlette, "To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States." The Commonwealth Fund | 1 | State requires individuals to maintain adequate health coverage (effective 2020) | State has not established a financial penalty or other enforcement mechanism to promote compliance with the mandate requirement |
| State subsidies for individual market coverage | J. Giovannelli, K. Lucia, and S. Corlette, "To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States." The Commonwealth Fund | 2 | State provides premium and cost-sharing subsidies for individual market coverage | State provides premium and cost-sharing subsidies for enrollees with incomes up to 300% FPL (subsidies are in addition to federal premium tax credits and cost-sharing assistance) |
| <p>State regulation of short-term limited duration coverage </p> | J. Giovannelli, K. Lucia, and S. Corlette, "To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States." The Commonwealth Fund | 2 | State regulations are stricter than the federal government: short-term coverage is allowed, but contract duration and the length of time a consumer can be enrolled is limited | Short-term coverage contract duration limited to 3 months, and coverage cannot exceed 3 months in a 12-month period |
| <p>State decisions to extend the annual open enrollment period for ACA marketplace coverage </p> | J. Giovannelli, K. Lucia, and S. Corlette, "To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States." The Commonwealth Fund | 0 | State did not extend the open enrollment period for 2018 coverage and has not yet announced an extension for 2019 enrollment period | - |
| <p>Rules to a promote competitive marketplace </p> | J. Giovannelli, K. Lucia, and S. Corlette, "To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States." The Commonwealth Fund | 1 | Individual and small-group markets are merged to the create a broader risk pool | In 2014 and 2015, Vermont required all individual market coverage to be sold through the ACA marketplace. Beginning in 2016, insurers under contract with the marketplace were permitted to enroll individuals directly. |
| State decisions regarding whether to allow non-compliant transitional policies in the individual market | J. Giovannelli, K. Lucia, and S. Corlette, "To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States." The Commonwealth Fund | 0 | State prohibits insurers from selling non-compliant transitional policies in the individual market | - |
| <p>State decisions to exempt other coverage products from federal and state consumer protections</p> | J. Giovannelli, K. Lucia, and S. Corlette, "To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States." The Commonwealth Fund | 0 | State does not exempt other coverage products from federal and state rules for individual market insurance | - |
| <p>Status of state Affordable Care Act innovation waivers</p> | J. Giovannelli and K. Lucia, "States See Opportunities for Flexibility in the ACA’s Innovation Waiver Program." The Commonwealth Fund | 4 | Waiver withdrawn from federal consideration/no longer under active federal review | Waiver application submitted to the federal government in 2016. Application failed preliminary federal review (application missing required elements) on June 9, 2016 and has not been resubmitted by the state. Application sought to waive requirements related to the small business health insurance marketplace (the “SHOP”). |