Legislatures weigh hospital pricing authority, data-center permitting, overshadowing review and multiple budget and policy measures
Committee meetings across both chambers on May 19 covered a range of policy matters, with high-priority discussion of hospital pricing and board authority, permitting and enforcement for data centers, a technical advisory committee report on “overshadowing” for potable water and wastewater systems, and multiple spending and policy items in appropriations and other committees.
Ways & Means — reference-based pricing, Act 68 and provider tax reporting
The House Ways & Means Committee reviewed S.197 and related amendments and revisited provisions from last year’s Act 68. Committee discussion described Act 68 as having ordered the Green Mountain Care Board to commence reference-based pricing for hospital fiscal year 2027, a timeline the board could not meet because of a protracted rulemaking process. Committee members said the amendment before Ways & Means would authorize the Green Mountain Care Board to begin reference-based pricing for hospital fiscal year 2027 and allow the board, when issuing hospital budget guidance or orders, to direct related savings to two identified vulnerable markets.
Members also discussed hospital budget provisions under the bill that would express hospital prices as percentages of Medicare or another benchmark and adopt a Medicare-adjusted base rate for statewide reference-based pricing. Committee materials referenced potential percentage benchmarks including 150%, 250% and 300% of Medicare and cited mechanisms for limiting hospital reimbursements. An amendment presented would pare back some sections and remove a provision that would have increased a cap on outpatient prescription drugs administered in hospitals from 120% average sales price to 130%.
The committee addressed hospital outsourcing and a provider tax element in the bill, including a requirement that, for fiscal year 2027 budgets, the Green Mountain Care Board shall direct hospitals to provide information the board requires about clinical services outsourced to external entities. The board, after consulting hospitals and contractors, would report findings and recommendations on outsourcing and, in collaboration with the Agency of Human Services, report on the extent outsourcing affects provider tax revenue and recommend any necessary changes to provider tax statutes by January 15, 2027.
Ways & Means members also discussed a requirement for critical access hospitals by October 1, 2026, to identify outpatient services where charges equal five times or more the Medicare allowed amount and to post disclosures related to Medicare beneficiary cost sharing, with proposed disclosure materials to be filed with the Green Mountain Care Board for approval. Other bill sections would direct the Agency of Human Services to report baseline per-person-per-month primary care spending and to establish targets and a transitional schedule for primary care spending, with a report back in January 2028.
Energy & Digital Infrastructure — data centers, Act 250 and enforcement authority
The House Energy & Digital Infrastructure Committee focused on permitting and oversight for qualifying data centers and related land-use authority. Committee members reviewed S.202 and addressed overlaps between the Public Utility Commission process and the Act 250 land use permitting framework. Testimony noted the potential duplication of checking compliance through the PUC when district commissions already impose permit conditions and enforcement authority exists under 10 V.S.A. chapter 201 for environmental law enforcement.
Committee presenters said wrapping conditions into an Act 250 F-250 permit would make those conditions enforceable through chapter 201 enforcement, reducing the need for duplicative PUC enforcement. The committee also discussed organizing Act 250 provisions in statute, a proposed renaming of a suitability analysis to “project design suitability analysis,” and concerns about a rebuttable presumption provision tied to surface water withdrawal permits. Members recommended keeping Act 250 matters in chapter 151 and cautioned that a surface water withdrawal permit does not necessarily align with a presumption regarding undue water pollution.
Committee conversation touched on timing pressures as session adjournment approaches and options for moving bills to conference or to the floor, including requests for rule suspensions to expedite action.
Environment — S.212 amendment directing TAC report on overshadowing
The House Environment Committee reviewed a draft amendment to S.212 (draft 3.1) that would add a new section directing the Technical Advisory Committee (TAC) at the Agency of Natural Resources to prepare a report on “overshadowing” by potable water supplies and wastewater systems. The amendment would require the secretary to report on authority under statutes and rules that allow isolation distances for potable water supplies and wastewater systems to extend onto neighboring properties, a practice commonly known as overshadowing. The TAC report would summarize the scientific and technical basis and benefits to public health and the environment from overshadowing.
Agency witnesses said the amendment narrows the TAC’s scope to items within the committee’s expertise and that the direction is appropriate for reevaluation. The Drinking Water and Groundwater Protection Division indicated support for the amendment. Committee members discussed TAC capacity and that preparing the report would require reprioritizing TAC work between now and January.
Appropriations (House and Senate) — S.193, feasibility and spending oversight; Senate budget items
Multiple appropriations panels examined S.193 and other spending proposals. House Appropriations members discussed S.193 language and a feasibility approach in place of premature rulemaking. Amendments from Appropriations would add a subsection stating that absent further legislative enactment, the Agency of Human Services shall not advance the development of a forensic facility beyond what is required to complete the feasibility plan.
🍁 Make a One-Time Contribution — Stand Up for Accountability in Vermont 🍁
Members debated legislative oversight and the sequencing of contracts and spending, with concern about agencies entering contracts and later requesting funding. The House panel said the feasibility plan would identify staffing, clinical services, security planning and discharge and community monitoring plans, and listed interim cost estimates and options such as out-of-state placement or competency restoration programming while a Vermont facility is pending. Witnesses described the proposed facility as a secure, agency-of-human-services residential facility for certain people involved in the criminal justice system, including those found incompetent to stand trial or not guilty by reason of insanity for a limited set of offenses that carry a lifetime maximum penalty.
Separately, the Senate Appropriations Committee addressed multiple budget items in bills before it. Members discussed adding positions supported by retirement boards, one-time and pilot funds for town highways and transportation programs (including a $3,000,000 special fund and using 75% of surplus funds for a special fund in S.75), funds to continue rural transit and driver hiring efforts, and one-time support for educational and community legal programs. The Senate committee also reviewed positions proposed for mediator services at the State Labor Relations Board and an attorney at the Ethics Commission, with cost estimates referenced.
General & Housing — solicitation at correctional facility parking lots and landlord-tenant matters
The House General & Housing Committee considered Senate amendments to S.230 and discussion about solicitation on state property. A Senate-added provision requires the Commissioner of Corrections, Buildings and General Services, and the VSEA to meet and consider solicitation in parking lots at correctional facilities; committee witnesses reported that such a meeting already occurred. Testimony noted an historical statewide policy limiting solicitation at state office buildings and that the Commissioner of Corrections has delegated authority over correctional facility grounds, but some commissioners have not adopted a policy. Committee members debated whether to concur with Senate amendments, concur with further amendment, or seek conference, noting tight session scheduling.
The committee also considered landlord-tenant language referenced to fair housing law, including reasonable modification and reasonable accommodation requirements and the interplay between termination of tenancy and disability-related conduct. Witnesses from the Human Rights Commission and others discussed existing fair housing protections and how landlord-tenant and fair housing statutes interact.
Judiciary — H.642 juvenile jurisdiction adjustments and policing bills debate
The House Judiciary Committee reviewed Senate changes to H.642 concerning court jurisdiction over young people nearing age 22, explaining the house bill expanded the court’s ability to extend jurisdiction in specified circumstances for youth whose probation or supervision would otherwise lapse upon turning 22. Committee discussion noted few Senate changes and debated victim impact statement language and drafting details. In separate Judiciary sessions members debated amendments and constitutional questions raised by bills addressing law enforcement conduct and masking by agents; members expressed differing views on constitutionality and enforcement implications.
Health Care — H.583 reporting and deadline changes for private equity disclosures
The House Health Care Committee reviewed Senate proposals of amendment to H.583, an act relating to clinical decision making. Committee counsel reported Senate changes beginning on page eight involve the timing of reporting ownership and control of certain health care entities. The amendment moved the date by which health care facilities and management services organizations must provide attestations about private equity or hedge fund ownership from July 1, 2026, to March 1, 2027, while retaining the ownership interest effective date of June 1, 2026. The amendment also requires the Green Mountain Care Board to collaborate with relevant stakeholders to develop reporting processes and requires the Agency of Human Services to provide necessary data to the board.
Government Operations & Military Affairs — H.954, Stowe charter and local tax testimony
The Government Operations & Military Affairs Committee heard testimony on H.954, amendments to the charter of the town of Stowe, and broader testimony in favor of a 1% local-option tax. Local business owners testified in support of a 1% tax to generate funds for local infrastructure and to spread the tax burden between residents and visitors. The committee received business-level testimony describing local economic and infrastructure needs.
Judiciary (additional) — S.209/H.849 and related amendments on masking and federal agents
The House Judiciary Committee also heard testimony and deliberated on amendments related to S.209 and H.849 concerning law enforcement identification and masked agents. Members debated constitutional risks and policy needs, referenced recent actions in other states, and discussed whether state-level restrictions on federal agent conduct are legally supportable. Committee members took motions on draft amendments and expressed differing views about moving forward given constitutional concerns and the desire to address public safety and identification issues.
Conclusion
These reports cover committee meetings held May 19 and include deliberations in Ways & Means, Energy & Digital Infrastructure, Environment, Appropriations (House and Senate), General & Housing, Judiciary, Health Care, Government Operations & Military Affairs and related panels. Committees discussed hospital reference-based pricing and Green Mountain Care Board authority, data-center permitting and enforcement within Act 250, a TAC report on overshadowing for potable water and wastewater systems, a variety of spending and feasibility study requirements in appropriations, and policy matters ranging from parking-lot solicitation at correctional facilities to health care ownership reporting and law enforcement identification provisions.
FYIVTBOT | FYIVT
You can find FYIVT on YouTube | X(Twitter) | Facebook | Instagram
#fyivt #vtleg #goldendome #vermontpolitics
Support Us for as Little as $5 – Get In The Fight!!
Make a Big Impact with $25/month—Become a Premium Supporter!
Join the Top Tier of Supporters with $50/month—Become a SUPER Supporter!
Subscribe to RSS
Leave a Reply