Public Assets Institute > Policy Areas > Health Care > Health Care Reform: Obama and Vermont Are Moving in the Same Direction

Health Care Reform: Obama and Vermont Are Moving in the Same Direction

Steven Kappel (December 2008)

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President-elect Barack Obama’s health plan includes features to make health coverage accessible to more Americans, to make health insurance markets work better, and to broaden the base of people who pay for the system. At the same time, the federal plan allows states to continue their own reforms. Several aspects of the Obama plan are already in place or under development in Vermont, and the proposed flexibility should enable the state to continue to make progress with its reforms.

Like Vermont’s recent efforts, the Obama plan leaves much of the existing system in place, while attempting to control costs, reduce the number of uninsured people, and improve prevention and public health activities. Along with its commitment to provide coverage for all Americans, the plan’s emphases on health information technology, coordination of care, disease management, and wellness, mesh well with Vermont’s efforts, including the state’s Blueprint for Health, Catamount Health, and Vermont Information Technology Leaders (VITL).1 Guaranteed eligibility, a cornerstone of Obama’s health insurance market reform, has been a requirement in Vermont’s individual and small group markets since the early 1990s.

For nearly 20 years, Vermont has been a national leader in health care reform. Further progress in Vermont—especially when it involves integrating Medicare beneficiaries and funds into a new system—will require cooperation from the federal government. The compatibility of Obama’s and Vermont’s visions greatly improves the odds that cooperation will be forthcoming.

The tables below compare major features of the Obama plan2 with Vermont’s current health care system and reform efforts.The initiatives are categorized into four major policy areas: pharmacy, clinical care, insurance reforms, and federal changes.






Suggested Reading

The Obama plan is available at


President-elect Obama has written about his plan in several places, including:

Journal of the American Medical Association 300 (2008): 1927-8.

New England Journal of Medicine 359 (2008): 1537-41.


A critique of the plan was published in Health Affairs 27 (2008): w462-71.


Additional information on the Obama plan can be found at:

•The Commonwealth Fund –

•The Economic Policy Institute –



1Vermont Information Technology Leaders is a nonprofit whose mission is to expand the use of information technology in health care.

2All information on the Obama plan from 11/9/2008

3Generic drugs have active ingredients that are identical to brand-name drugs, but are sold at a lower price after the

original patent on the drug expires.


5For information on the Blueprint, see



8Community rating guarantees that the same insurance coverage costs any individual or group the same premium, regardless of health status.

9Federally funded State Children’s Health Insurance Program.




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© 2008 by Public Assets Institute

This research was funded in part by the Annie E. Casey Foundation and the Public Welfare Foundation. We thank them for their support but acknowledge that the findings presented in this report are those of the Public Assets Institute and do not necessarily reflect the opinions of the foundations.