This report from the Urban Institute examines Vermont's attempt at comprehensive health reform, drawing attention to the positive effects of premium subsidies along with robust outreach and enrollment strategies. It explores the lessons learned in the context of the Affordable Care Act (ACA) in order to identify ways that the ACA can build upon these experiences.  

From the report:

Vermont’s comprehensive health reform law, the Health Care Affordability Acts (HCAA) for Vermonters, was passed in 2006 with the following three goals in mind:  

• To achieve universal access to affordable health insurance for all Vermonters
• To improve quality of care and contain costs through health system reform
• To promote healthy behavior and disease prevention across the lifespan

To achieve the first goal, the HCAA created two programs intended to provide access to affordable insurance to the state’s uninsured: The Catamount Health Insurance Program (Catamount Health) and the Employer-Sponsored Health Insurance (ESI) Premium Assistance Program. Blueprint for Health (which is currently being implemented) is an initiative that was created to address the second and third goals of the HCAA, focusing on the prevention and management of chronic conditions to improve quality of care and reduce health care costs (Conis, 2008).

Full Report: Achieving Universal Coverage through Comprehensive Health Reform: The Vermont Experience – Evaluation Results (PDF | 227 KB)

Urban Institute. (2011). Achieving universal coverage through comprehensive health reform: the Vermont experience - evaluation results. Deprez, R., Glied, S., Kappel, S., Rodriguez, K., Perry, B., Robertson, B., Schwabe, N., and Tilipman, N.