Some towns to field resolution on universal health care bill

People will go to the doctor if they have no out-of-pockets, they’ll get treated earlier, before their condition is so serious, and it will keep people out of the emergency room, which adds a great deal of spending to our total expenditures.
— Ellen Oxfeld

ADDISON COUNTY — As a retired pediatrician, Middlebury resident Jack Mayer has seen firsthand how high insurance deductibles and out-of-pocket costs can prevent Vermonters from going to the doctor. It’s a challenging decision that can prove to be detrimental for the individual’s health, as well as costly for everyone.

“If you identify someone with high blood pressure in a primary care physician’s office, and you treat them with simple, safe, inexpensive medication, that’s a lot cheaper than treating someone’s stroke that occurs down the line because their blood pressure was untreated,” Mayer explained. “Not only is it devastating to them personally, but it is enormously expensive.”

Mayer and other local residents are seeking action on H.433, a bill in the Vermont Legislature that aims to “implement Green Mountain Care, a publicly financed health care program for all Vermont residents.” The universal health coverage would begin with primary care in the first year then incorporate other health care services later on. It’s among a handful of bills aimed at reforming the state’s primary care and broader health care systems that lawmakers could dive into this session (see related story on Page 1A).

Supporters of H.433 see it as a way to address high health care costs and ensure more Vermonters get the medical care they need. The bill is currently sitting in the Vermont House Committee on Health Care, where it was referred early last year.

In an effort to prompt lawmakers to consider H.433, community members have petitioned to get a resolution regarding the bill on town meeting warnings in several area towns, including Middlebury, Bristol and Cornwall.

Voters in those towns will field a resolution asking whether they should “call upon the General Assembly to discuss, take testimony, and vote on H.433 during the 2026 session?”

“We’re just asking for this democratic process to unfold because clearly the (population) wants this issue debated, and they want the Legislature to take action, and we’re at a critical crisis point in our health care funding, and it’s only going to get worse,” Mayer said.

Ellen Oxfeld is another Middlebury resident involved in the effort. She noted many of the challenges Vermont currently faces are linked to health care spending, such as affordability issues within the state’s public education system. Oxfeld pointed to a 2024 report on hospital sustainability in Vermont commissioned by the state and conducted by the independent consultant Oliver Wyman Group, which stated savings could be achieved by expanding access to primary care.

“You can understand why, right, because people will go to the doctor if they have no out-of-pockets, they’ll get treated earlier, before their condition is so serious, and it will keep people out of the emergency room, which adds a great deal of spending to our total expenditures,” Oxfeld said.

The Vermont Chamber of Commerce last month stated that Vermont’s health care system now “totals $2.5 billion and accounts for nearly 30 percent of the state budget when federal dollars are included.”

Oxfeld noted that in the current system, a substantial portion of health care spending goes toward administrative costs. She pointed to figures comparing the number of billing clerks employed by the Duke University hospital system (1,300 billing clerks as of 2013) to the less than 10 employed by a hospital system in Canada, which has universal, publicly funded health care.

“So that can show you that so much of the cost of our system is not in caring for people but all the admin,” Oxfeld said.

Oxfeld and Mayer also emphasized that many Vermont residents are underinsured. A 2025 Vermont Household Health Insurance Survey released by the Vermont Department of Health stated 187,800 Vermonters met one of the Commonwealth Fund’s definitions of being underinsured.

“That is, either their current or their potential future medical expenses are more than what their income could bear,” the report states.

Mike Palmer lives in Cornwall and petitioned to get the H.433 resolution on the town meeting warning there. He underscored how costs can prevent underinsured Vermonters from seeking medical care, something he’s seen personally.

Palmer and his late brother both had access to the same health care system in Vermont, but while Palmer was able to regularly receive primary care that detected several conditions over the years, his brother was not.

“As a result, there were things that developed that could have been prevented,” Palmer said. “We’re talking about real people, not just numbers.”

Through the health care program proposed in H.433, all Vermonters would be eligible for primary care without deductibles, copayments orother cost-sharing requirements in the program’s first year, with additional health care services added to the benefit package over the course of 10 years.

It’s an idea Oxfeld, Mayer and Palmer found many community members support.

“It was so easy to get signatures. The public is ready for this,” Oxfeld said. “It would be like 10 degrees outside, and we’d be outside the co-op or the post office, and we’d start to explain what this was about, and people would say, ‘Oh, give me the pen I want to sign.’”

Linda Andrews and Mark Gibson collected signatures for an H.433 petition in Bristol. Gibson noted they received 293 signatures — well over the 170 required for a petition in Bristol — and that most residents were enthusiastic about signing.

“Healthcare yes, yes, yes was the general reaction,” Gibson said in an email exchange.

He added Andrews collected signatures at the town’s waste transfer station, which provides a random sampling of residents.

“So it does seem a big majority are embracing this measure at least at this point,” Gibson said.

Citizens looking to have their selectboard add an article to the town meeting warning must submit a petition that’s signed by at least 5% of the town’s voters. The Vermont Secretary of State’s Office notes that while the selectboard can warn advisory or non-binding articles that are petitioned, “it is only required to do so if they relate to town business.”

As of Wednesday morning, the Cornwall, Middlebury and Bristol selectboards had agreed to include the H.433 resolution on their town meeting warnings. Petitions regarding H.433 had also been submitted to selectboards in Salisbury, Weybridge and outside of the county in Putney.

Palmer said Vermonters led similar initiatives in St. Johnsbury and Fairfax, with efforts locally and in other parts of the state getting underway more recently.

“My sense is if we had started in October…this would be extremely widespread across the state,” Palmer said.

Mayer noted the conversation around publicly financed health care is one that’s been going on for decades, and H.433 offers an opportunity for Vermont to act.

“I think this is an opportune moment, right now, as we are facing the crisis of a possible, really, collapse of our health care system,” Mayer said. “It’s an opportunity for us to finally do what we should have done 50 years ago.”