['Employee Benefits']
['Health Plans']
07/17/2024
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Summary of differences between federal and state regulations
The U.S. Department of Health and Human Services (HHS) must make a determination on or before January 1, 2013, that a state will in fact have an exchange in operation by 2014 and that the exchange meets the requirements of the Affordable Care Act (ACA) and HHS guidance. In a letter dated November 15, 2012, Secretary Sebelius indicated that states may submit both a letter of intent and an application to operate its own exchange by December 14. If a state elects not to operate an exchange, or if the HHS determines that the state will not be able to have an exchange operational by 2014 that meets the law’s requirements, the ACA gives the HHS the authority to establish and operate such exchange within the state.
In May 2011, Governor Shumlin signed HB 202 into law, which put Vermont on a path toward establishing a single-payer health care system. The law created the Vermont Health Benefit Exchange to meet the requirements of federal health reform. In 2017, the state plans to apply for a federal Waiver for State Innovation to transition to Green Mountain Care, a new public-private single-payer system that will provide coverage for all Vermont residents. Governor Shumlin signed additional health reform legislation (HB 559) in May 2012, further defining the role and duties of Green Mountain Care Board and the Exchange.
To date, Vermont has received a $1 million federal Exchange Planning grant, a $36 million Early Innovator Grant, and an $18 million Level One Establishment grant.
By December 14, 2012, Vermont must submit an exchange blueprint consisting of a declaration letter signed by Governor Shumlin and an application to the U.S. Department of Health and Human Services, indicating whether it plans to operate a state-based exchange or a state-federal partnership exchange.
State
Contacts
Department of Vermont Health Access
Regulations
Vermont Statutes, Title 8, Chapter 107: Banking and Insurance
Vermont Statutes, Title 33, Chapter 18: Public-Private Universal Health Care System
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