The proposed bill aims to provide Medicaid-equivalent coverage to all Vermont residents, regardless of household income, through a phased implementation based on age bands. The coverage will be rolled out starting in 2029 for individuals up to 26 years old, with subsequent age groups added in the following years, culminating in full coverage for all residents by 2033. The bill mandates the Agency of Human Services to seek federal approval for financial participation in this expanded coverage and stipulates that the state will cover the costs if federal approval is not granted. Additionally, the Agency is tasked with estimating the costs and developing a detailed implementation plan for the program.

To support the financial obligations of this initiative, the Department of Taxes is required to report on potential payroll tax options by January 15, 2027. This report will explore various structures for a payroll tax to generate necessary revenue, both with and without federal funding. The bill also includes provisions for the Agency of Human Services to provide cost estimates and a detailed implementation plan to relevant legislative committees by January 15, 2026. The effective date for the Medicaid-equivalent coverage is set for January 1, 2029, while other provisions of the act will take effect upon passage.