Vermont

Financial struggles have pushed Vermont’s largest health insurer to the brink – VTDigger

Published

1 year ago

May 7, 2025

Financial struggles have pushed Vermont’s largest health insurer to the brink – VTDigger

Don George, president and CEO of BlueCross BlueShield Vermont, listens during a roundtable on health care costs hosted by U.S. Sen. Bernie Sanders, I-Vermont, in Burlington on Friday, May 31, 2024. Photo by Glenn Russell/VTDigger

Over the past several months, Vermont lawmakers and state officials have been preoccupied with the fate of the state’s largest health insurance company.

Blue Cross Blue Shield of Vermont, the Vermont-based member of the nationwide health insurance organization, is also the only health insurance company based in Vermont. The nonprofit covers roughly a third of the state’s population across all its plans.

Now, with its reserves drained by a multi-year surge in insurance claims, the nonprofit is facing a financial crisis with little recent precedent. As Blue Cross Blue Shield prepares to ask state regulators to increase premiums in 2026, the financial health of the company has alarmed policymakers and prompted a scramble to shore up the company.

“If Blue Cross cannot pay the claims, the system fails,” Owen Foster, the chair of the Green Mountain Care Board, a key health care regulator, told lawmakers last month.

Federally qualified health centers, independent clinics, mental health agencies, possibly even hospitals — “if they don’t get paid, they close their doors,” Foster said.

The financial headwinds facing Blue Cross Blue Shield are familiar to many in Vermont’s health system. In the wake of the Covid-19 pandemic, hospitals and other providers have seen a surge of patients, many presenting with more complex conditions. What’s more, the price of care — particularly drugs, and more particularly specialty drugs, like popular weight-loss medications known as GLP-1s — has increased precipitously in the past few years.

That’s led to unexpected increases in health care expenditures across the state. In both 2023 and 2024, for example, the University of Vermont Medical Center exceeded its budgets by tens of millions of dollars — overages that, hospital administrators said, were caused by a massive surge in patients needing more care.

That surge has, in turn, drained Blue Cross Blue Shield’s cash reserves. From 2021 through the end of 2024, Blue Cross Blue Shield has lost nearly $152 million, according to data the insurer presented to legislators earlier this month. Last year alone, Blue Cross lost $62.1 million.

In 2019, the insurer had $133.5 million in the bank. At the end of 2024, Blue Cross Blue Shield had just $58 million — and pays out an average of $35 million a week in claims.

Last year, credit rating agency A.M. Best downgraded Blue Cross Blue Shield’s rating twice, bringing its score from B++ to C++. That’s moved the insurer’s rating from “good” to “marginal” in a matter of less than six months.

“I’ve lived and worked in Vermont for 45 years,” Don George, the CEO of Blue Cross Blue Shield, told lawmakers in the Senate Committee on Health and Welfare last month. “And I’ve just never seen anything remotely close to what we’re going through now.”

‘We’re fortunate’

A significant chunk of those losses have come from Blue Cross Blue Shield’s Medicare Advantage plans, Vermont Blue Advantage. From 2019 through 2023, Blue Cross Blue Shield lost $43.4 million on those plans, according to financial records. Roughly 35,000 Vermonters are on Blue Cross Blue Shield Medicare Advantage plans, Sara Teachout, a spokesperson for the insurer, said.

Some of those early losses were startup costs ahead of the plans’ rollout in 2021, Teachout said. Once they hit the market, the plans continued to lose money — $11.5 million in 2022 and $22.5 million in 2023 — along with the rest of the insurer’s portfolio, records show.

Those deficits are due to the same factors affecting the rest of Blue Cross Blue Shield’s generally, Teachout said: a rise in residents needing care and increasing costs for that care.

Those losses “are proportionate to the losses in our other lines of businesses that are due to the cost surge,” she said.

To shield itself from those losses, Blue Cross Blue Shield of Vermont has almost entirely unloaded its Medicare Advantage business onto Blue Cross Blue Shield of Michigan, an affiliate nonprofit insurer. It’s also taken out a $30 million loan from Blue Cross Blue Shield of Michigan.

Because of its shaky financial footing, Blue Cross Blue Shield of Vermont is paying 8% interest on that Michigan loan. George, the CEO, said in an interview that the insurer was lucky to have even gotten a loan in the first place.

“The reality is, we would likely — under those circumstances and that risk — not be able to find anyone that would loan Blue Cross Blue Shield of Vermont (money),” he said. “So we’re fortunate to have Michigan, and that’s how we come up with that interest rate.”

To shore up its finances, the insurer has also held off hiring roughly for 30 positions and has embarked on a “comprehensive capital recovery plan” with the Department of Financial Regulation, according to George.

‘The number one cost driver’

As part of an annual regulatory process, Blue Cross Blue Shield is preparing to request increases to its insurance premiums later this month — increases that are expected to be large. Last year, the insurer raised premiums for individual and small group plans on the state’s health insurance marketplace by roughly 20%.

For 2026, “Given the pace of medical and pharmacy costs and the utilization that we saw right through to the end of 2024, I would expect increases not unlike what we’ve recently seen in the past,” Ruth Greene, the insurer’s chief financial officer, said in March.

Those increases impact not only individual Vermonters’ insurance costs — already some of the highest in the nation — but also their taxes. Most municipalities buy small group insurance plans on the state health insurance market, according to Ted Brady, the executive director of the Vermont League of Cities and Towns.

Prior to last year’s premium increases, roughly 80% of municipal employees were insured with Blue Cross Blue Shield, Brady said, although he now expects that many municipalities have switched to MVP, the other insurer that sells on the marketplace.

“Health insurance is the number one cost driver for municipalities right now,” he said.

School and state employees are also insured on Blue Cross plans, but are on a different type of plan known as self-funded plans. Although those organizations have also seen significant premium increases as health care costs rise, members contribute proportionally less to Blue Cross’ reserves — meaning they are more insulated from the insurer’s financial struggles, administrators at those organizations say.

Still, increasing insurance premiums are “a tremendous economic strain on every part of Vermont,” Vermont’s Chief Health Care Advocate Mike Fisher told lawmakers last month.

‘Acute and immediate threat’

Meanwhile, policymakers and legislators are taking steps on their own. In March, the Green Mountain Care Board, a key health care regulator, announced a deal with the University of Vermont Health Network that will deliver $12 million in hospital funds to Blue Cross Blue Shield of Vermont.

Lawmakers are also hashing out the details of a bill that would allow for emergency action to help health insurers in financial crisis. That bill, H. 482, would allow the Green Mountain Care Board to reduce the reimbursement rates paid to a Vermont hospital if the insurer in question faces “an acute and immediate threat to its solvency.”

Such a rate reduction would only be allowed if the hospital is part of a financially stable network, according to the bill language.

The proposed legislation passed out of the House in March. A key legislative committee, the Senate Health and Welfare Committee, is scheduled to vote on advancing it Friday.

Meanwhile, in the other chamber, the House’s health committee is looking to address the problem of rising costs closer to their source — at hospitals and other providers.

A sprawling bill, S.126, would implement a new payment model known as reference-based pricing, in which hospital charges are pegged to Medicare reimbursement rates, to go into effect no later than 2027. The bill would also direct the Agency of Human Services to work with providers to reduce health care spending by 5% “for hospital fiscal year 2026,” which begins October 1.

That bill passed the Senate in March, and lawmakers in the House Health Care Committee are working on amendments this week.

“There’s a lot of work that has to be done,” Sen. Ginny Lyons, D-Chittenden Southeast, the chair of the Senate Committee on Health and Welfare, said of her committee’s legislation last month. “We can’t let Blue Cross and Blue Shield go under.”

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Vermont

Vermont teen dies in crash with tree

Published

2 hours ago

May 9, 2026

Press Room

A teenager died when his car crashed into a tree in central Vermont on Friday afternoon, police said.

The 16-year-old was pronounced dead at the scene of the crash, off Creek Road in Clarendon, Vermont State Police said. They identified the teen as Jacob Smith, of Proctor.

Troopers were notified about the crash about 2:39 p.m., police said. Investigators found that Smith drove off the east side of the road before hitting the tree; he was wearing his seatbelt, but his car, a Volkswagen Passat, was totaled.

Police didn’t say what they suspect led up to the crash. They asked anyone with information to call Trooper Charles Gardner at 802-773-9109, or email him.

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Vermont

VT Lottery Mega Millions, Gimme 5 results for May 8, 2026

Published

14 hours ago

May 9, 2026

Press Room

Powerball, Mega Millions jackpots: What to know in case you win

Here’s what to know in case you win the Powerball or Mega Millions jackpot.

Just the FAQs, USA TODAY

The Vermont Lottery offers several draw games for those willing to make a bet to win big.

Those who want to play can enter the MegaBucks and Lucky for Life games as well as the national Powerball and Mega Millions games. Vermont also partners with New Hampshire and Maine for the Tri-State Lottery, which includes the Mega Bucks, Gimme 5 as well as the Pick 3 and Pick 4.

Drawings are held at regular days and times, check the end of this story to see the schedule.

Here’s a look at May 8, 2026, results for each game:

Winning Vermont Mega Millions numbers from May 8 drawing

37-47-49-51-58, Mega Ball: 16

Check Vermont Mega Millions payouts and previous drawings here.

Winning Gimme 5 numbers from May 8 drawing

06-10-11-36-37

Check Gimme 5 payouts and previous drawings here.

Winning Pick 3 numbers from May 8 drawing

Day: 3-6-1

Evening: 0-3-6

Check Pick 3 payouts and previous drawings here.

Winning Pick 4 numbers from May 8 drawing

Day: 6-3-7-3

Evening: 7-1-6-1

Check Pick 4 payouts and previous drawings here.

Winning Millionaire for Life numbers from May 8 drawing

14-16-21-43-51, Bonus: 03

Check Millionaire for Life payouts and previous drawings here.

Feeling lucky? Explore the latest lottery news & results

Are you a winner? Here’s how to claim your lottery prize

For Vermont Lottery prizes up to $499, winners can claim their prize at any authorized Vermont Lottery retailer or at the Vermont Lottery Headquarters by presenting the signed winning ticket for validation. Prizes between $500 and $5,000 can be claimed at any M&T Bank location in Vermont during the Vermont Lottery Office’s business hours, which are 8a.m.-4p.m. Monday through Friday, except state holidays.

For prizes over $5,000, claims must be made in person at the Vermont Lottery headquarters. In addition to signing your ticket, you will need to bring a government-issued photo ID, and a completed claim form.

All prize claims must be submitted within one year of the drawing date. For more information on prize claims or to download a Vermont Lottery Claim Form, visit the Vermont Lottery’s FAQ page or contact their customer service line at (802) 479-5686.

Vermont Lottery Headquarters

1311 US Route 302, Suite 100

Barre, VT

05641

When are the Vermont Lottery drawings held?

Powerball: 10:59 p.m. Monday, Wednesday, and Saturday.
Mega Millions: 11 p.m. Tuesday and Friday.
Gimme 5: 6:55 p.m. Monday through Friday.
Lucky for Life: 10:38 p.m. daily.
Pick 3 Day: 1:10 p.m. daily.
Pick 4 Day: 1:10 p.m. daily.
Pick 3 Evening: 6:55 p.m. daily.
Pick 4 Evening: 6:55 p.m. daily.
Megabucks: 7:59 p.m. Monday, Wednesday and Saturday.
Millionaire for Life: 11:15 p.m. daily

What is Vermont Lottery Second Chance?

Vermont’s 2nd Chance lottery lets players enter eligible non-winning instant scratch tickets into a drawing to win cash and/or other prizes. Players must register through the state’s official Lottery website or app. The drawings are held quarterly or are part of an additional promotion, and are done at Pollard Banknote Limited in Winnipeg, MB, Canada.

This results page was generated automatically using information from TinBu and a template written and reviewed by a Vermont editor. You can send feedback using this form.

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Vermont

Alison Clarkson’s legacy in Vermont legislature – Valley News

Published

1 day ago

May 8, 2026

Press Room

Alison Clarkson’s legacy in Vermont legislature – Valley News

WOODSTOCK — Alison Clarkson and Mike Marcotte started in the Vermont Legislature the same year, after winning election in 2004. Beyond that, they would seem at first not to have much in common.

Marcotte, a Republican, grew up in Newport, Vt., near the Canadian border, while Clarkson, a Democrat, grew up in Buffalo, N.Y., in a politically active family, went to Harvard and then produced theater in New York City before moving to Vermont in the 1990s. They’re from opposing parties at a time of growing partisanship, and it’s safe to say that where Marcotte is a steady, no-nonsense Vermonter, Clarkson is more outspoken, a live wire, even.

State Sen. Alison Clarkson, D-Woodstock, greets a group of her supporters from Woodstock, including her campaign treasurer Ann Boyd, foreground, during a recess in the Senate during their visit to the state house in Montpelier, Vt., on Thursday, May 8, 2026 for “Alison In Action Day.” The group toured the building and watched proceedings from the Senate gallery before having lunch with Clarkson. JAMES M. PATTERSON / Valley News

“Alison’s flamboyant, to say the least, but her heart is in the same place mine is,” Marcotte said in a phone interview. She wants to help the people of Vermont and “when you’re working on the subjects that we’re working on, there’s no political divide there,” he said.

And so as chairman of the Vermont House Commerce and Economic Development Committee, Marcotte, R-Coventry, has worked closely with Clarkson, D-Woodstock, who chairs the Senate Committee on Economic Development, Housing and General Affairs.

For example, together with their committees, they developed the state’s new Office of Workforce Strategy and Development, an administrative agency overseen by the governor’s office.

But now after serving in the House for six terms and five terms in the Senate, this term will be Clarkson’s last. She will leave Montpelier after 22 years with a reputation for working doggedly for her constituents and for bridging a previous generation of lawmakers, particularly in the Senate, and a new, younger corps who are picking up the baton.

“Building trust and building relationships, that’s how you get things done,” Clarkson said. “You’ve got to take time to get to know each other.”

Marcotte, who also has decided not to seek a new term, has seen this belief, and Clarkson’s work ethic, in action.

“I just think that she’s done the job that she was elected to do, over and above what the expectations were,” Marcotte said.

A varied career

Clarkson first ran for the Vermont House seat representing Woodstock and Plymouth in 2004. She was 49 at the time and had two children in school. Her eldest, Ward Goodenough, was in boarding school, and William was at Woodstock Elementary, age 10.

To put the length of her career in the Legislature into perspective, both of her boys got married last summer. Ward is Windsor County State’s Attorney and Will works for Indeed, the job search website, in New York City.

Her career in the Statehouse has been varied, which has kept her going. “There is no same-old, same-old” in the Legislature, she said.

She served on the Judiciary Committee and on Ways and Means, which writes tax policy, in the House, and served two terms as majority leader in the Senate.

The Legislature’s achievements during her tenure were groundbreaking, including the 2009 passage of the state’s gay marriage law, and expanding a patient’s choices at the end of life, the so-called “death with dignity” law, which passed in 2013. The state also has tightened gun safety laws.

And much of this work was completed with women leading the Legislature. At one point, all four top legislative positions were held by women, Clarkson noted. She called it “the golden age of women in leadership,” in Vermont.

In recent years, Clarkson has been in the forefront of efforts to pass consumer protection laws, and to improve opportunities for working Vermonters through economic development, by virtue of her committee chairwomanship.

“I love the range of it,” she said of leading the Economic Development, Housing and General Affairs Committee. The “general affairs” part of the title includes regulating alcohol and cannabis, labor issues and consumer protection, including data protection.

The state’s crises

But the list of issues that have resisted solution over the past two decades is long and consequential, topped by the cost of health care, the state’s fragmented education landscape, and the affordability crisis that has priced many young and working people out of the state, despite a desperate need for workers.

The difficulty of addressing these issues stems in part from Vermont’s small size up against global economic forces, Clarkson said. Gov. Phil Scott, a Republican, has run on affordability over the past decade and there hasn’t been much improvement.

“There’s what things cost, that we have little control over,” Clarkson said. “Then there’s what people are earning.” Vermont underpays, she said.

That means residents who work remotely from Vermont at jobs in larger markets out-earn their neighbors who are reliant on the local economy. And housing, in particular, is part of a global market. This, too, is not a new problem.

“People with New York and Boston incomes are coming here and buying homes, which is driving prices higher,” Clarkson told the Valley News in October 2004, during her first campaign for the House.

Now, she said, “I have a son who’s trying to buy a house in the town he grew up in and it’s brutal.” Woodstock could use 300 units of housing right away, “and it would all be full,” she said.

Through her committee’s work, she has seen how time-consuming it is to encourage housing construction. A new housing law enacted last year, and measures under consideration this year, will take time to bear fruit.

Public education will likely have to undergo a form of regionalization at the middle and high school level, Clarkson said, and she suspects that some of the state’s small elementary schools will close or merge if they are no longer viable.

But she doesn’t see much appetite for a sweeping redrawing of school districts, either among the public or among lawmakers. There’s pressure to cut costs, but it’s also possible that, as high as the price tag may be, the state is spending what it should be spending on education, Clarkson said.

She was the first lawmaker to argue that the state shouldn’t be sending public education money to out-of-state private schools, a practice that was curtailed under Act 73, the sweeping education law enacted last year.

“My concern is that the Legislature could decide to spend less and rein in education spending to the point where it would be punitive,” Clarkson said. “I’m not sure we’ve found the sweet spot yet in the financial model,” she added.

Building trust

As much as she has tried to build relationships in Montpelier, she worries that there isn’t going to be enough trust built up among lawmakers to solve the state’s most pressing problems.

Since she started in the House, fewer lawmakers stay overnight in the capital, and there are fewer events where lawmakers get together, Clarkson said. It’s easier for people who get to know each other to work together and make deals.

“I would say the Legislature has not really made it a priority to build the relationships to move beyond partisanship,” Clarkson said.

Even so, the process still works pretty well, she said. Legislators have to meet in committee and get to know each other there. And everyone hears the same testimony, so they’re working from the same facts.

Being a legislator is a people-focused job, Clarkson said.

“If you aren’t genuinely interested in people and what their needs are, and how we solve the problems they face, you won’t last long in the Legislature,” she said.

While Clarkson is very much a joiner — her husband, law professor Oliver Goodenough, called her “naturally gregarious” — she can also come off as a forceful personality.

When she first met Clarkson, in 2016, state Sen. Becca White, D-Hartford, found her off-putting.

“She was such a starkly different political figure than anyone I had ever met,” White said in a phone interview. Clarkson is a “loud, in-charge type of person,” as White is herself, she acknowledged.

White, then a Hartford Selectboard member barely of legal drinking age, was interested in running for a vacant Windsor District Senate seat. Clarkson invited her up to the Statehouse for lunch.

White was the lunch, pretty much. Clarkson told her, ” ‘I’m going to go out there and I’m going to win it,’ ” White recalled. “I chose, at that point, not to run for Senate.”

She did later run successfully for the House, and for Senate in 2022. For White, and for Sen. Joe Major, who was elected in 2024, Clarkson has been a transitional figure.

When she reached the Senate in 2017, Clarkson’s colleagues in the Windsor District delegation were Dick McCormack, who retired last year, and Alice Nitka, two veteran Democrats. Both had been around long enough to cast votes for Act 60, the state’s landmark education finance law, in 1997, shortly before White turned 3.

“Alison is one of my most formative mentors,” White said.

And they’re good friends. Clarkson’s outsize personality makes it easier for White to be “a more authentic version of myself,” she said.

It helps, too, that Clarkson knows everyone in and around the Statehouse.

“She knows exactly who she is, and she works extremely hard,” White said.

With lawmakers like Clarkson, 71, and her collaborator Marcotte, 67, leaving the Statehouse, another generational shift is underway.

“I do see a lot of folks who are exhausted,” White said, particularly in the House.

The biggest change in her 22 years as a legislator, Clarkson said, was the volume of email. Sifting through and responding to it has made the job harder, the days longer.

Looking ahead

Clarkson realized in 2024 that she was facing her last term in Montpelier.

“I got to the end of the campaign and I just knew I didn’t want to have to campaign again, for myself,” she said in an interview at her Woodstock home.

Those last two words are important. While she’s leaving the Legislature after this term, Clarkson plans to stay engaged in politics and public life. She’ll help with other campaigns and stay involved in issues where she feels she has something to offer.

“The gift of this building,” she said in a phone interview from the Statehouse lounge, where she works until 11 or 11:30 most nights, “is you see all the opportunities and all the needs.”

Post-Legislature, Clarkson plans to take on one opportunity, establishing a new culinary school in Vermont, and one need, becoming a guardian ad litem.

Vermont is a farm-to-table state, Clarkson said, and has struggled to train people for its vibrant restaurant scene since the closure of the for-profit New England Culinary Institute in 2021.

“When NECI closed, we lost a very important workforce development pipeline,” she said. The school also brought students into the state.

Clarkson first learned of the guardian ad litem, or GAL, program when she was on the House Judiciary Committee. A GAL is a trained volunteer who represents children in court, particularly in cases of abuse or neglect.

Vermont currently has 278 GALs, but needs around 400.

“I think I could be helpful,” she said.