Vermont’s hospitals are in trouble. A new analysis found that the state’s hospitals would need as much as $3 billion in subsidies — from commercial insurance increases or taxpayers — to remain solvent over the next five years, if immediate steps aren’t taken.
That figure comes from a 142-page report outlining a plan to radically transform the state’s health care delivery system to bring down costs while continuing to provide access to care.
The report was mandated by statute and put together by the consulting firm Oliver Wyman, whose team conducted a series of meetings with thousands of patients, health care workers, hospital leaders and advocates over the past year.
“There is no hospital in Vermont that is not in jeopardy,” stressed Dr. Bruce Hamory, a consultant who specializes in redesigning health delivery and former infectious disease physician who led work on the report.
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“You just can’t afford inaction,” he said at a presentation Wednesday to Vermont’s health care regulators, the Green Mountain Care Board.
Some of the headwinds facing the state’s costly health care system:
Commercial insurance rates are some of the highest in the country, and have increased by double digits for three years in a row, far outpacing the national average.
Most of the state’s 14 hospitals are operating at a loss, and those losses are expected to worsen in the coming years.
Vermont’s population is aging and shrinking, which will put further strain on the health care system and workforce.
Patients face long wait times for primary care and specialty care and have inadequate access to community based services, leading to expensive, sometimes unnecessary hospital visits.
Low-income households in rural areas face some of the greatest barriers to accessing care, stemming from a lack of affordable housing, transportation, and culturally competent care.
The report outlines a litany of recommendations to change the trajectory of health care finances in the state. Even with immediate action, experts caution it will take time to bring down commercial insurance rates.
“Probably two years minimum, if things really move,” Hamory said.
Restructure hospitals in the most dire financial straits
Four of Vermont’s hospitals — Grace Cottage Hospital in Townshend, Gifford Medical Center in Randolph, North Country Hospital in Newport and Springfield Hospital — have the most untenable finances based on the population they serve, according to the report.
Over the next three years, Oliver Wyman consultants say hospitals will need to close or reconfigure inpatient units to stay viable.
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“Every prediction I can make, with every trick I know to pull, says that within three to five years, your bank will call the bill and close you,” Hamory said. “You need to be prepared.”
Some hospitals admit just one or two patients a day.
“The number of people really affected by not having in-patient acute care services is very small,” Hamory said.
That space and staff could be repurposed to provide other services, like mental health care, memory care, or skilled nursing facilities.
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The report also suggests emergency departments could be converted to urgent care centers or shifted to a non-physician model.
Elodie Reed
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Vermont Public
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North Country Hospital, in a file photo from 2020. The report says that for the four hospitals it recommends suspending inpatient operations, nearby facilities are available to care for those patients at other hospitals, besides at North Country Hospital.
Closing inpatient services is a major concern for Mike Del Trecco, the head of the Vermont Association of Hospitals and Health Systems.
“For a hospital in the Northeast Kingdom, where are people going to go?” he said during a phone interview.
“This work is predicated on having out-patient community services available, and those don’t exist.”
The outgoing and incoming leaders of one of these hospitals, Gifford Medical Center, said they were also disappointed by many of the recommendations.
“While we knew this report to the state was coming, its contents are, frankly, shocking,” outgoing president and CEO Dan Bennett wrote in an emailed statement. “We will continue to advocate strongly for Gifford, for our patients, for our team members, for our future—to ensure Gifford is here to provide care in our region for generations to come.”
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Michael Costa, who will lead Gifford starting in mid-October, added that the suggestions “have the potential to harm rural communities and some of the most vulnerable Vermonters.”
“I am particularly concerned that the report could reduce health care choices for Vermont’s women,” Costa wrote in an emailed statement.
In the report, Gifford Medical Center is cited as having a low volume of births attended by an obstetrician — though Gifford contends that the quality of that perinatal care is “exceptional” when compared against statewide data.
Joia Putnoi
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Vermont Public
Specialized equipment for a newborn baby at Gifford Medical Center in December 2022.
Springfield Hospital CEO Robert Adcock echoed Gifford Medical Center’s concerns.
“We do not support a path that reduces access to care and requires our patients to travel great distances for critical health care needs,” Adcock wrote in an emailed statement. He added that hospital leadership is “open to any recommendations that improve access to care for patients, help grow our workforce, and support a thriving Springfield community.”
For other hospitals in the state, the report calls for expanding certain specialties and discontinuing low-volume procedures.
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Del Trecco, with the Vermont Association of Hospitals and Health Systems, questioned the practicality of that idea. “These organizations that would be looked to to enhance or increase their capacity, they don’t have the physical plant, they don’t have the staffing,” he said.
“The savings of these recommendations have to be clearly studied, and frankly, the resources necessary to implement these recommendations also have to be studied,” he added.
Carly Berlin
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Vermont Public and VTDigger
Copley Hospital in Morrisville on Oct. 19, 2023.
And rearranging where health care services are offered can have drawbacks for both patients and the people working in health care.
“We don’t want to pretend that health care professionals are interchangeable or easily moved or retrained,” Jessa Barnard, the executive director of the Vermont Medical Society, which advocates for physicians and PAs, said during a phone interview. “I do worry about the fear factor.”
Move care out of hospitals
Providing health care in a hospital setting is far more expensive than at a doctor’s office or at home. As many as a third of emergency department visits are avoidable at some hospitals if adequate community care was accessible, according to the report.
Shifting care away from hospitals, however, has already been a major focus of health care reform efforts.
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“That’s been what we’ve been trying to do for a decade,” Owen Foster, the chair of the Green Mountain Care Board said at the meeting Wednesday.
“Yeah, and not very well,” Hamory responded.
Foster said the state needs to change its regulatory requirements to make it easier to build new health care projects like free-standing surgery centers, imaging centers, and birthing centers (Vermont is one of eight states that does not have a free-standing birthing center).
The report also calls for growing telehealth and home-based care, and expanding the roles of pharmacists in providing vaccines, refilling chronic medications, and treating common illnesses.
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Amy Kolb Noyes
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Vermont Public File
The report calls for reforms to EMS operations in Vermont.
Emergency medical technicians could also provide an expanded role in health care delivery, but funding mechanisms needs to change, according to the report. Now, EMS crews are only paid if they transport a patient to the hospital; they don’t get money for a return trip or for transferring patients between hospitals, and their work needs to be regionalized.
“I know it is running into many of the same discussions about consolidating schools — Vermont has 79 or so different EMS crews,” Hamory said.
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Invest in housing, transportation, broadband and out-patient services
To address issues of health equity, the report recommends increasing efforts to recruit and retain health care providers from diverse ethnic, language and religious backgrounds, and suggests investing in primary care, mental health facilities and substance misuse treatment that all populations can access.
That’s on top of addressing inadequate housing and transportation, which the report says should help Vermonters receive more regular care and avoid costly inpatient stays and emergency department visits.
“Many of those things are underway and have been underway for years,” state Sen. Ruth Hardy, a Democrat from East Middlebury, said at the Wednesday meeting, referencing legislation related to broadband, developing housing, and an ongoing EMS study committee.
But the current housing and transportation landscape is not adequate to support the recommended changes, said Del Trecco, with the Vermont Association of Hospitals and Health Systems.
“A key to this work, and it’s predicated on fixing housing, fixing transportation and having community outpatient services. We have none of those things in the four communities [where hospitals are recommended to close inpatient units], and very little in Vermont to begin with,” he said.
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Rein in costs at Vermont’s largest hospital
The University of Vermont Medical Center drives more than half of the state’s commercial insurance spending on hospitals but does not provide adequate access to specialty services, according to the report.
It recommends the hospital hire external consultants to help it reduce administrative costs, eliminate specialty programs that don’t see enough patients, and improve physician productivity to be more in line with national standards.
It also says UVM Health Network should reevaluate whether its medical education and research programs are contributing to better health outcomes for Vermonters.
“The funds used for both these purposes come largely from clinical dollars generated from patient care, and most of those dollars are from commercial insurance premiums,” Hamory said.
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Zoe McDonald
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Vermont Public
The University of Vermont Medical Center drives 56% of the state’s commercial insurance spending on hospitals, according to the Oliver Wyman report. Its physicians are spending about a third of their time on administrative roles and research duties, rather than seeing patients.
In an email Wednesday, UVM Medical Center spokesperson Annie Mackin wrote that upon initial review, the hospital agrees with a number of the Oliver Wyman report’s recommendations, including the focus on housing.
“So many challenges we are facing in health care, which are mirrored in other complex systems in our state, come back to our inability to attract and retain working Vermonters,” she wrote.
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She added that the hospital disagrees with the portion of the report that cites high administrative costs, saying that it was “based on a flawed analysis of data.”
Mackin also wrote that UVM Medical Center is “proud to be an academic medical center, teaching the next generation of physicians here in Vermont, and conducting cutting-edge medical research.”
Next steps
Some are anticipating strong pushback to many of the details in the report.
“This is scary,” Mike Fisher, the state’s health care advocate, acknowledged at the meeting Wednesday.
“In the world of policy, it is easier to kill an idea than it is to pass a good idea,” he said. “I’m sure that is playing out today in messages to legislators and others.”
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Howard Weiss-Tisman
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Vermont Public File
Springfield Hospital in 2019.
Hamory stressed the need for immediate action.
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“Starting tomorrow, the convening of communities and hospitals to plan for and implement the needed changes in health care delivery must begin,” he said.
That includes specific actions items for Vermont lawmakers, the Agency of Human Services (AHS) and the Green Mountain Care Board (GMCB):
In the Legislature, the consultants recommend lawmakers continue actions like:
Remove barriers for new housing.
Expand broadband coverage to rural areas for EMS transport.
Fund an overhaul of EMS services so they are regionalized.
Expand professional licensure for nurses, EMTs and pharmacists.
At the Agency of Human Services, the report says:
Specialty care and EMS services should be regionalized.
Care management should be better coordinated, including through statewide electronic medical records.
And for the Green Mountain Care Board, the report instructs:
Streamline its regulatory processes.
Do not license any more hospital-based outpatient units.
Encourage free-standing diagnostic, heart disease and birthing centers.
Start to move toward pricing that’s 200% of Medicare levels, or less.
Have questions, comments or tips? Send us a message.
With all the talk of right wing men having a hard time finding a partner, I really was surprised to discover that Stephen Miller, the inspiration for many of Trump’s cruelest immigration policies, had a wife. But, I then was unsurprised that his wife, Katie Miller, has an anti-feminist podcast. Also no surprise: she has been lamenting that the US fertility rate is falling rapidly. But here is the true shocker: who can we blame for that rotten news?
“Since 2007, the teen birth rate has fallen 72%. Hormonal birth control isn’t just poison for women’s minds and bodies — it’s killing population growth. For the first time ever, birth rates for women in their late 30s have surpassed those in their early 20s.”
And to add to the horror of it all, according to Marc Siegel, a talking head on Faux News masquerading as a senior medical analyst, the following actually qualifies as a social problem, and we should be very worried: ”We’re telling people that are young not to have babies, to wait ‘til they’re in a more stable life situation, ‘til they’re more financially secure, maybe they haven’t found the right partner.”
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Yes, the very idea of waiting until you have met someone you can see raising a child with, maybe you even deeply love, have enough financial resources to live independently of your hard working parents or parent, and even a high school diploma, is too much for the MAGA crowd in the face of a worse crime: a declining fertility rate.
I guess I missed something: have not the good Christians of the past been horrified by teen sexual activity? In the very recent past, within even the memory of the youngest voters, did teens who engaged in wanton sexual activity not face punishment? Did I imagine the many demands for “abstinence only” sex “education”?
Maybe the push to accept and welcome children having babies is something else altogether: more “Handmaid’s Tale,” and less allowing the kids to relax about sex.
I have to wonder if part, or even all, of this hand wringing is directly related to the rape culture ushered in by electing a president whose followers thought it was cool that he had bragged about grabbing a woman by the “pussy,” and was convicted of molesting a woman in a department store dressing room. Secretary of War Crimes, Pete Hegseth, is mad full of the teachings of a raving lunatic, Doug Wilson, pastor of possibly the most misogynist sect in a country full of weird allegedly Christian teachings, the Communion of Reformed Evangelical Churches.
At the schools associated with this cult, Amanda Marcotte writes: “Students at ACCS schools who said they were sexually abused by teachers reported being blamed for causing the older men to ‘stumble.’”
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And of course, the cherry on the pie for the pro-natalist crowd, Planned Parenthood is the devil and always being deprived of funds that could help women and families actually have some agency in choosing when and if to have kids. And abortion is the worst sin! Senator Josh Hawley is currently attempting to make safe abortions illegal by pressuring a corrupt FDA to declare that mifepristone is unsafe for use —with Republican Senate enthusiasm.
So this push for teen pregnancies may actually not be condoning sex between consenting teens as much as acknowledging the number of young girls who are victims of men who are family members, employers, teachers, politicians, and all the men who see Donald Trump and his ilk as role models. The drip, drip, drip of information about the Dear Leader and rape of a 13-year-old girl continues. Trump acolyte Matt Gaetz has been very credibly accused of child trafficking and statutory rape. While he resigned from Congress, he continues to hold his Florida law license.
This is a dangerous moment for girls — we who grew up with the feminist movement understand and lived what we hope we left behind. Rape was taken as a joke until women forced the issue. I do not need to remind anyone of the many challenges of teen pregnancy. I raised three children — as a full grown adult. I can’t even imagine having taken on the day after day parenting struggles as a 17-year-old, much less at age 14. While the trumpers are doing their best to create a dystopian society, we cannot forget what we, and the suffragettes before us, have achieved in the struggle for women’s rights. No ambiguity 3 — our rights are being challenged by men who believe that the worst elements of the past must be the future. Well, we say no!
Nancy Braus is a long-time political activist who writes from Guilford. The opinions expressed by columnists do not necessarily reflect the views of Vermont News & Media.
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.
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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 April 29, 2026, results for each game:
Winning Powerball numbers from April 29 drawing
03-19-35-51-67, Powerball: 15, Power Play: 2
Check Powerball payouts and previous drawings here.
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Winning Gimme 5 numbers from April 29 drawing
13-19-20-23-35
Check Gimme 5 payouts and previous drawings here.
Winning Pick 3 numbers from April 29 drawing
Day: 6-8-3
Evening: 3-1-7
Check Pick 3 payouts and previous drawings here.
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Winning Pick 4 numbers from April 29 drawing
Day: 5-8-0-5
Evening: 4-6-3-1
Check Pick 4 payouts and previous drawings here.
Winning Megabucks Plus numbers from April 29 drawing
01-04-20-24-39, Megaball: 03
Check Megabucks Plus payouts and previous drawings here.
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Winning Millionaire for Life numbers from April 29 drawing
05-10-17-21-42, Bonus: 02
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.
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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
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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.
Claire MacQueen has no plans to have children anytime soon. It is not a question of desire or emotional readiness. MacQueen, 27, has always felt called to motherhood, envisioning it as one of life’s most fulfilling endeavors.
“Not just to be a mom, but a really good one,” she said.
MacQueen, a technical writer at a software company, said she simply can’t afford it.
Although MacQueen and her partner both work and have minimal debt, they feel unable to get far enough ahead of expenses to take the plunge. A large chunk of their shared income gets gobbled up by the $2,000 they spend each month on utilities and rent for their one-bedroom Burlington apartment.
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Claire MacQueen at her home in Burlington on 24 April 2025. (Daria Bishop for 7 Days)
The couple desperately want to buy a house, which would provide room to start a family and allow them to start building equity. Instead, they have been forced to raid their savings to cover more pressing expenses: vet bills, car repairs, large medical fees.
Having a child right now feels irresponsible, MacQueen said. She has no idea when that might change.
“A lot of things will need to fall into place,” she said.
Many young Vermonters making such calculations are coming to a similar conclusion. They are holding off on having children and having fewer when they ultimately do. Vermonters in their twenties and thirties overwhelmingly point to affordability as the key reason. Many also express a growing unease about the future and express doubt that they’ll be able to provide their children with a better chance to succeed than they had growing up. These factors, cited in interviews and responses to a query Seven Days posted on social media, show that the dwindling number of young Vermonters is partly due to the state’s high costs of housing and health care, both of which have proved difficult to fix.
For more than a decade, Vermont has had the nation’s lowest birth rate. The actual number of children born in the Green Mountain State is smaller today than before the Civil War, when Vermont had fewer than half as many residents it does now. Since Donald Trump was elected president, the inflow of immigrant families, which tend to be relatively larger, has slowed to a trickle.
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The state’s high cost of living and an almost impenetrable housing market have made it difficult for young Vermonters to achieve the traditional milestones — marriage and homeownership — that they expect to reach before having children.
“You don’t have to be an economist or read the Wall Street Journal to know that today’s generation is not automatically getting ahead,” said Karen Benjamin Guzzo, a demographer at the University of North Carolina at Chapel Hill. “A lot of people look at their own lives, then envision the future and say, ‘I don’t know if I should do this.’”
Birth rates in affluent nations have declined for decades. After resisting the trend, the U.S. is now in the midst of its own sustained drop. Vermont’s rock-bottom position suggests that it is experiencing a particularly dramatic version of dynamics playing out elsewhere in the country.
The impacts extend well beyond the empty desks that are driving Vermont’s debate over school consolidation. While fewer births ease strain on the environment and public services, the trend also means that fewer young workers are available to fill job openings or support the growing population of seniors as baby boomers retire.
Countries have been trying for years to crank up birth rates through cash incentives or tax breaks, with little to no success. And the factors that appear to discourage Vermonters of childbearing age are hardly new. The state’s politicians have discussed the dearth of affordable housing and the rising cost of health care for years; Vermonters pay the highest insurance premiums in the nation. Progress in addressing these costs has been limited.
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One area where Vermont has made strides toward easing the financial burden of parenthood is childcare. Major investments into its system have won plaudits for successfully expanding capacity and bringing costs down for some. Wait lists remain common, though, and some families still wind up paying $1,000 a month or more.
What seems clear is that any attempt to populate the state with more young Vermonters requires that policy makers address the dollars-and-cents anxieties of potential parents such as MacQueen.
How Low Will We Go?
Vermont wasn’t always a poster child for the baby bust.
In 1960, near the tail end of the baby boom, Vermont’s birth rate was slightly above the national average, at 126 per 1,000 women of childbearing age.
Over the next few decades, births in Vermont tracked national trends, generally declining as more women entered the workforce. Then, in the mid-1990s, Vermont’s births dropped precipitously to well below national rates.
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It is hard to pinpoint what triggered the nosedive. But one potential explanation is that the shift toward waiting longer to have children — what demographers call the “postponement transition” — began to play out in Vermont much earlier than elsewhere.
Vermont is a highly educated, left-leaning state with comparatively low rates of religion. The first groups to delay childbearing en masse coming out of the women’s movement? Secular liberals who attended college and used their early twenties to earn degrees and launch their careers.
Whatever the reason, Vermont’s birth rate remains far below the national average. Vermont recorded 5,023 births in 2024, more than 1,500 fewer than annual tallies from the late 1850s. The state’s fertility rate is 41.5 per 1,000 women of childbearing age, lagging the national average of 53.
The question now is how much further Vermont’s birth rate may fall.
Younger people today report greater ambivalence about having children than past generations. And Seven Days heard from several couples in their thirties who say they’ve decided to not have children at all.
Still, national surveys suggest that the overwhelming majority of people still say they want children — between two and three, on average. They’re just having fewer — perhaps because the longer couples wait, the harder it is to get pregnant. Female fertility declines with age. A 25-year-old woman is two to five times more more likely to conceive as a woman who is 40.
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Guzzo, the demographer, said she’s amused when people are surprised by the trend toward delayed parenthood. For decades, the U.S. sought to discourage women from having children until they could properly support them.
“We shamed teen moms. We shamed unintended pregnancies,” she said. A lesson drummed into members of today’s generation was to be sure they had everything in order before having children.
“A lot of people just don’t feel ready,” she said.
It Takes a Village — and a Home
In interviews, the most common reason Vermont couples gave for holding off on children was the desire to better establish themselves financially. That may include paying off student loans or saving up to afford childcare.
Very often that means buying a home, which can be a Herculean task in a competitive housing market such as Vermont’s, where prices have risen far faster than incomes.
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The median home price in Vermont has doubled over the past decade, to about $500,000. A couple would need to earn at least $150,000 a year, based on current interest rates, to comfortably afford such a home. And that’s only if they can manage to scrounge up $100,000 for a down payment.
It’s nearly impossible to find the type of classic, affordable starter home that allowed past generations to build equity. Builders are no longer interested in them, citing low margins amid rising construction costs. Exacerbating the shortage of available single-family homes is a trend toward aging in place, coupled with a lack of affordable options for Vermont’s burgeoning senior population.
The new units coming online now are predominantly studios and one-bedroom apartments — not exactly suitable for young families.
James Mullin and Emmaleigh Hancock, two young professionals in their late twenties, say they’re struggling to envision homeownership in Vermont.
Mullin works as a legal assistant at a law firm, and Hancock is pursuing a PhD in molecular physiology and biophysics at the University of Vermont. Once she graduates, Hancock plans to attend a postdoctoral program elsewhere, likely at the University of Arizona, which specializes in the type of cardiac research she’s conducting.
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After that, the couple said they want to return to Vermont to start a family.
And yet the salary Hancock expects to make with her degree wouldn’t likely be enough for them to afford a home in the area, they said.
Mullin, who was born and raised in Addison County, has resigned himself to the possibility that his own children won’t grow up in the Green Mountains.
“We want to buy a house, and we want to have kids,” he said. “It just feels like you can’t do both here.”
Even those who decide to put homeownership on the back burner say they’re not sure how they’d pay for kids in Vermont.
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Raised in Utah, Katherine Ham came east for college and chose to accept a teaching job in Vermont for the same reasons she now thinks it would be a great place to raise children. “The different seasons, the culture, the close-knit communities,” she said. “It’s such a beautiful, wonderful place.”
Ham, now 24, wants to start her family soon, in part to give her older parents plenty of time with their grandchildren. But the one-bedroom apartment in Colchester that she rents with her wife has neither the space nor amenities they’d like for an infant.
“I’m not going to have a child without a washer and dryer,” Ham said.
A friend recently sent them a Zillow listing for a suburban townhouse in Philadelphia. The $1,900 monthly rent matches what they pay now and would get them three bedrooms and two bathrooms spread across two floors. It also comes with laundry hookups. Ham predicted they’d move within the year.
One and Done
Vermont’s falling birth rates can be explained to some degree by the decisions of couples such as Rachel Bishop, 29, and Zach Bish, 32, who, in February 2025, welcomed their first child — and, they insist, their last.
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Proudly “one and done,” the Barre couple said they have decided against a second child after carefully considering the pros and cons.
On one hand, parenting has been tremendously fulfilling, Bishop said, each month bringing the equivalent of a “software update” to the living, breathing being she created.
“Now all of a sudden she’s walking,” Bishop said. “That’s been insanely cool.”
But Bishop, who works as a funeral director, believes that she has enjoyed the experience in part because having only one child to care for has allowed motherhood to augment, rather than supplant, her life.
“My whole identity hasn’t been taken over,” she said.
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She worries that might change if she were to add a second child to the mix. In addition, she doubts that they’d be able to afford another kid.
The savings the couple built up before she got pregnant evaporated after she took off a few months from work to care for their newborn, which left her husband’s job selling motorcycles as their only income source. She’s now back to work full time and covering their monthly expenses. But despite a generous state subsidy, childcare still costs $600 a month.
There’s a difference, Bishop said, between getting by and building the type of life that she wants for her family. “If my kid wants to be able to go to a dance class or play a sport, I want to be able to afford that, too.”
Bishop said she’s been told repeatedly by friends, family and even strangers in the checkout line that she’ll change her mind. She’s skeptical. She and her husband would need to work more hours to afford a second child, at the risk of missing their daughter’s childhood, which already feels like it’s flying by.
Love is not a finite resource. But time, money and attention do seem to have a spending limit.
Rachel Bishop
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“Love is not a finite resource,” Bishop said. “But time, money and attention do seem to have a spending limit.”
For Amanda Northrop and Jordan Armstrong, the question of a second child was left unanswered for the first half of their 10-year-old daughter’s life.
Northrop was a 33-year-old grad school student at the University of Vermont when she gave birth. Armstrong had just started working as a lab tech at the UVM Medical Center. They managed to purchase a home thanks to some familial generosity: Armstrong’s mother sold them her house in South Burlington and gifted the down payment. But the couple still had to rely on childcare, paying upwards of $1,500 some months.
“It was like a second mortgage,” she said.
Amanda Northrop and her daughter, Rosalind Credit: Daria Bishop
The couple somehow made it work, taking on debt to cover their expenses, and Northrop assumed that they would eventually have another child.
Then their daughter entered the public school system, and the monthly childcare bill disappeared, providing Northrop a profound sense of relief. That’s when the decision solidified in their minds: They wouldn’t have any more children.
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Now 43, Northrop, who works as a biologist, feels confident that they made the right call, partly because Vermont’s increased cost of living has made it even more difficult to get by. To save money, the family limits how often they eat out. When they take the rare vacation, they stick to places within driving distance.
Her daughter, whom Northrop describes as a “cool kid” that will “talk your ear off about frogs,” has gradually accepted that she’ll be an only child. But every now and then, Northrop said, her daughter still asks about the prospect of having a sibling one day, a trace of sadness in the girl’s voice.
Baby Benefits
Expanded tax credits. A $5,000 “baby bonus.” Granting parents more voting power than those without children. These are just some of the ideas officials in the Trump administration have floated over the past year to slow America’s declining birth rate.
They reflect the growing influence of a faction of conservatives known as “pronatalists,” who believe the government should establish policies that promote procreation.
Critics note an irony in the White House’s embrace of a more-babies mantra at the same time that it is slashing the social safety net that many low-income families rely on.
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There’s another reason to be skeptical: Policies that seek to incentivize women to have children haven’t worked in other countries.
“A baby bonus or tax credits, they’re not bad. No one’s going to say no to money,” said Guzzo, the demographer. But for families on the fence about children, $5,000 is unlikely to make much of a difference, she said.
What could help, demographers say, are policies that make it easier for people to balance starting families with their careers. That often begins with affordable childcare.
Vermont has made some notable progress toward that goal. In 2023, the state installed a payroll tax to help raise an annual $125 million to bolster the childcare system. The money has been used to expand subsidies for families and provide better funding to childcare providers.
The funding has been credited with adding more than 1,700 new childcare slots, and thousands more families now qualify for at least some assistance, including those making more than $200,000.
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Parents who qualify for assistance pay the same “family share,” or co-pay, regardless of how many children they enroll in a program. For bigger families, the savings can be quite substantial: upwards of $20,000 a year, in some cases. Some say they’ve chosen to have another child in part because they knew they would be able to maintain the same childcare payments, Seven Days has previously reported.
Still, challenges remain, including a persistent shortage of childcare slots for infants and a lack of awareness about how the subsidy program works. Many families likely don’t know that they qualify, or that they could pay the same rate they do now if they had another child.
It’s too soon to know whether the changes will have any impact on birth rates.
“It will take time for people to feel like they can rely on that,” said Dr. Kristin Smith, a family demographer and visiting associate professor at Dartmouth College.
Of course, childcare is only one piece of the affordability puzzle, and parents are delaying pregnancy for many reasons, some of which are well beyond Vermont’s control.
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An Uncertain Future
Cara Simoneau and her cat Lentil Credit: Daria Bishop
Cara Simoneau always pictured herself with a family and planned to start trying for kids at 27, the same age as Claire MacQueen. Then she reached that age and decided, like MacQueen, that she lacked the financial means.
Much has fallen into place in the eight years since. Simoneau and her husband now own a house in Jericho, which they closed on a few weeks before the pandemic lockdown started and Vermont’s housing prices began to skyrocket. Simoneau’s parents moved up to Vermont from Massachusetts and have offered to help out with childcare, which could save the couple thousands of dollars a year.
And yet Simoneau, now 35, still isn’t trying to get pregnant and can’t say for certain if she ever will.
A series of developments in the U.S. over the past few years — the second election of Trump, the reversal of Roe v. Wade by the majority-conservative U.S. Supreme Court and, most recently, the war in Iran — have unsettled Simoneau so deeply that she has paused her pursuit of motherhood indefinitely.
For people such as her, the decision of whether to have children transcends dollars and cents, hinging instead on less tangible factors such as trepidation over the future. Those modern anxieties can involve war, an overheating planet, growing political divisiveness and gun violence in schools.
For now, Simoneau is channeling her pent-up parent energy into doting on her two cats, Popcorn and Lentil. But she said she has also been evaluating her stance on children on a near-weekly basis as she confronts the reality that each passing month could make it more difficult for her to get pregnant.
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People around Simoneau support her decision. Her husband, who is three years younger, “very much understands that, at the end of the day, it’s going to be my body that’s changing,” she said.
If anyone is gently steering her toward a decision, it’s her sister, who seems thrilled at the prospect of having a kid around, “one that she can give back at the end of the day,” Simoneau said, laughing.
Simoneau said she feels sad when she thinks that she may never get to experience the joy of parenthood with her husband, whom she describes as the “most amazing, wonderful human being.” She daydreams about raising a child who bears his traits, or who “loves cats like I do, who wants to play video games, who wants to explore the woods.”
Yet more frightening for her, for now at least, is the idea of having children in a society that feels like it is crumbling around her.
She hopes the midterm elections in November will help her make a decision, one way or another. ➆
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The original print version of this article was headlined “Baby Bust | Vermont’s birth rate is the lowest in the nation. Why aren’t we having more kids?”
About the Series
Seven Days is delving into the far-reaching ramifications of the declining number of young Vermonters.
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