Five years ago, Vermont began an experiment with its Medicaid program. Under its Global Commitment to Health waiver, the state was given a great deal of flexibility in the way it ran its Medicaid program. In return, the amount of federal funds available to the state was capped ($4.7 billion over five years), and if it spent more than that, there would be no federal match available. The state did not go over the cap; in fact, it spent less, reports The Burlington Free Press.
To meet the cap amount, the state limited the Medicaid program’s annual growth to 9%. It was able to spend $260 million less than the cap and use the money to actually expand the program to provide subsidized health insurance to previously uninsured individuals and new programs for people with chronic diseases. In addition, premium subsidies were available for lower income people to purchase private insurance. The state also had the ability to limit the benefits available to newly eligible Medicaid beneficiaries and others for whom Medicaid was provided optionally.
