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Jun 18, 20261
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Vermont Governor Scott Vetoes Healthcare Reform Bill, Citing Need for Broader Reforms
Vermont Governor Phil Scott vetoed S.190, a healthcare bill designed to accelerate reference-based pricing savings for public school employees and ACA marketplace customers, citing the need for equitable reforms that benefit all insurance payers rather than targeted groups. House healthcare committee chair Alyssa Black criticized the veto as vengeful, saying the administration had collaborated on the bill's development.




Quick Facts
Who
Governor Phil Scott
What
Governor vetoed S.190 healthcare reform bill
When
Tuesday (letter announcing veto)
Where
Vermont
- Governor vetoed S.190 healthcare reform bill
- Bill would have accelerated reference-based pricing implementation
- Governor announced plan to use executive action for alternative reforms
- Care board called for $40 million in hospital revenue reductions
- Prior year saw nearly $100 million in hospital revenue reductions
Vermont Governor Phil Scott has vetoed S.190, a healthcare bill that would have accelerated premium savings for public school employees and individuals purchasing insurance on Vermont's Affordable Care Act marketplace. The measure was among the few healthcare reform initiatives passed by the Vermont Legislature during the session. Scott announced his decision in a Tuesday letter, stating he would instead pursue executive action to advance components of an alternative insurance reform proposal from his administration.
The vetoed bill would have expedited Vermont's implementation of reference-based pricing—a cost-control mechanism that ties hospital payments to external benchmarks, typically a percentage of Medicare rates—for the two targeted insurance groups. Lawmakers designed the measure to accelerate the timeline for implementing the pricing reform, which was set to begin statewide in 2025 but faced delays pending regulatory approval from the Green Mountain Care Board. However, Scott objected to the narrowly targeted approach, arguing it violated principles of equitable cost-sharing. "Vermont will not solve its affordability crisis by directing savings to some payers while excluding others," Scott wrote. "Lasting progress will require structural reforms that expand affordability, increase choices, and ensure savings are shared broadly across the system."
Scott emphasized that the Green Mountain Care Board—Vermont's primary healthcare regulator—has demonstrated capability to generate substantial savings within existing frameworks. He noted the board had called for $40 million in hospital revenue reductions in the current fiscal year, following nearly $100 million in reductions the prior year. Kaj Samsom, Vermont's insurance commissioner, supported this position, contending that targeting revenue reductions to only a minority of Vermonters through the bill's approach was problematic.
Representative Alyssa Black, D-Essex Town and chair of the House healthcare committee, strongly opposed the veto. Black had championed S.190 and stated that Scott's administration had been integral to its development alongside healthcare policy experts over two years of collaborative work. She expressed frustration at the governor's decision, saying the bill represented the culmination of sustained legislative-executive partnership. "It's almost like he's taking revenge. It felt vengeful," Black said. "How he vetoes something that was the one final step in everything that we have done collaboratively for two years, I cannot wrap my head around it."
Reference-based pricing remains a central component of Vermont's healthcare strategy, with lawmakers having set the state on a path toward universal implementation across all hospitals in 2025. The Green Mountain Care Board must complete a rulemaking process to finalize the change, which would not be finalized before the hospital fiscal year begins in October—the delay that S.190 sought to address for the two targeted insurance groups.
Why This Matters
Governor Scott's veto blocks immediate relief for thousands of Vermont school employees and ACA marketplace customers who would have benefited from accelerated cost-control measures. The decision reflects a broader tension between targeted healthcare relief and comprehensive system reform, signaling that future healthcare policy will depend on executive action rather than legislative compromise. This matters to Vermonters seeking affordable care, policymakers designing cost-control mechanisms, and stakeholders monitoring how reference-based pricing—a key cost-containment tool—will be implemented statewide.
Timeline & Sources
Jan 1, 2025
WireVermont lawmakers set the state on path to implement reference-based pricing for all hospitals statewide