Policy alternatives for out of state coverage were analyzed and scored to develop a recommendation for implementing out of state coverage under the provision of Green Mountain Care Single Payer (Act 48). The state is required by Act 48 to create an adequate health service network that will allow for the portability of Green Mountain Care across state borders (Hsiao W.C., 2011). Act 48 authorizes the adoption of rules to establish coverage for those who are temporarily outside of the state and intend to return and reside in the state of Vermont. Vermont’s open borders and substantial policy variations across the country requires that the system developed be portable between and among the states.
Policy alternatives for out of state coverage in the Green Mountain Care single were analyzed and scored using internationally accepted health models, health literature, and health policy. Four policy alternatives: no further action, a modified Medicaid program, a supplemental health benefit exchange, and a hybrid of a modified Medicaid program and a supplemental health benefit exchange, are models that may meet the requirements set forth by Act 48. The development of a hybrid model incorporating a modified Medicaid program and supplemental health benefit exchange is recommended to provide the most extensive and efficient multi-state coverage for all Vermont residents. Due to limited data on comparative models, further research is needed to support the development of this recommendation.