House advances H.721 to expand Medicaid eligibility for young adults, pregnant people and low‑income seniors

The House took major steps on healthcare policy when members amended H.721, the Medicaid Expansion Act of 2024, advancing changes to eligibility and state support for low‑income Vermonters.

Representative Houghton (member from Essex Junction), speaking for the Healthcare Committee, said the bill would extend Medicaid coverage for young adults up to age 21 and raise pregnancy coverage from 208% to 312% of the federal poverty level, estimating about 657 additional pregnant individuals would gain access to prenatal and postnatal care in the first year. "H.721 expands access to Doctor Dinosaur to young adults up to 21 years of age," Houghton said during second reading.

The bill also proposes to expand the Medicare Savings Program (MSP) for older Vermonters, raising the MSP level that covers both Medicare Part B premiums and cost sharing to 190% of FPL and increasing the threshold that covers Part B premiums only to 225% of FPL. Representative Houghton told the chamber the MSP expansion would cost the general fund an estimated $15,000,000 when fully implemented and predicted it would bring an estimated 19,217 more Vermonters into the program.

The bill's fiscal package was presented by Representative Andrews (member from Westford), who described Ways and Means amendments that would redefine Vermont net income (removing certain foreign income deductions), impose a new top corporate rate and raise some registration fees to help fund the expansion and unlock federal matching dollars. Appropriations reported an amendment clarifying intent to use a portion of the revenues generated by those tax changes for the bill's appropriations.

Opponents argued the proposal risks shifting people off federally subsidized private plans and increasing state costs. One member said the expansion could move "no fewer than 18,000 Vermonters" from subsidized private insurance to Medicaid and estimated a roughly $48,800,000 annual state cost under some independent estimates. Representative Houghton replied that many of those who would benefit do not currently receive federal premium tax credits and stressed that the American Rescue Plan subsidies expire at the end of 2025.

When the House called a roll‑call vote on whether to amend the committee report as recommended, the clerk recorded the roster and the presiding officer announced the tally: 92 yes, 39 no. The presiding officer declared the committee report amended and ordered third reading for the bill as amended.

What happens next: the bill, as amended and with the requested technical analyses directed to the Agency of Human Services, is ordered to third reading on the House floor and will return for final passage procedures.