Vermont ends yet another <a href="https://healthylife7.com/trump-has-quietly-throttled-an-agency-devoted-to-the-safety-of-american-healthcare/” title=”Trump Has Quietly Throttled an Agency Devoted to the Safety of American Healthcare”>healthcare reform experiment
Vermont Public |
By
Lola Duffort
Published July 28, 2026 at 5:07 PM EDT
April McCullum
/
Vermont Public
The state has quit a federal healthcare experiment it had once hoped could draw significantly more funding into Vermont, saying new terms put forward by the Trump administration nullified any potential upside
Vermont’s withdrawal from the so-called AHEAD model means the state will need to find a new way to raise and distribute extra cash to struggling primary care providers. It is increasingly difficult for Vermonters to access primary care, and the state had hoped that participating in the effort could bring back federal dollars that once bolstered a system suffering from a shortage of clinicians and low reimbursement rates
AHEAD was something of a successor to OneCare, Vermont’s prior experiment in payment reform, in which the state sought to compensate providers based on outcomes instead of individual procedures
OneCare shut down in 2024, and that same year, state officials announced they had been selected to participate in the federal reform effort. They signed a tentative agreement with the Centers for Medicare & Medicaid Services in early 2025
At the time, state officials calculated the deal could mean an extra $138 million in federal funds for healthcare in Vermont, Human Services Secretary Jenney Samuelson told state lawmakers Tuesday. But a subsequent renegotiation altered those terms significantly, she said, and capped additional payments at $10 million
“That overhaul would have meant, generally, that there was greater complexity to the healthcare payment models in Vermont, there would be less money coming into Vermont,” she said
OneCare had been used as an intermediary to distribute roughly $25 million raised from hospitals, insurers and the federal government to primary care providers, according to the Vermont Medical Society. Since OneCare’s closure, Medicare’s contribution to those primary care payments went away, and state officials had hoped AHEAD would bring them back
Samuelson said Tuesday that she believed the five-year funding Vermont anticipates receiving under the One Big Beautiful Bill Act should provide a stopgap for primary care
“We’ve got a runway to figure out what we have for the long term,” she said
For Vermont Healthcare Advocate Mike Fisher, the announcement came as no surprise. He’s long been skeptical of AHEAD, and lost what little optimism he had for the enterprise last year
“Since election day, since the Trump administration came into office, I think it’s been even clearer to me that there was a very low likelihood that it was going to make sense for Vermont,” he said
Fisher said the primary care programs Vermont wanted to use AHEAD to fund are valuable. But he expressed frustration that state officials spent so much time and reof success
“If it’s important and it works, we need to fund it,” he said. “Otherwise, you know, we just can’t wait for the feds to come through.”
