Vermont Medicaid Program Overview
Enrollment, funding, and managed care facts for Vermont Medicaid.
Get Vermont's Medicaid Fee Schedule →Enrollment
Vermont Medicaid covered approximately 0.15-0.17M people. KFF's total monthly Medicaid & CHIP enrollment tracker gives 145,403 (May 2026); healthinsurance.org's state guide gives 152,275 (October 2025); CMS's 2024 Medicaid Managed Care Enrollment report gives 165,372 (July 1, 2024). The spread reflects different reporting periods and continuing post-pandemic 'unwinding' redeterminations rather than a data conflict -- reported as a range across the earliest (CMS, mid-2024) and most recent (KFF, May 2026) figures.
Funding & federal match
Vermont has adopted ACA Medicaid expansion, effective 2014-01-01.
For FFY2026 (Oct 1, 2025 - Sep 30, 2026), Vermont's Federal Medical Assistance Percentage (FMAP) is 59.01%.
Delivery system & managed care
A large share of Vermont Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 0-100% of Medicaid enrollees.
Waivers
Vermont operates Medicaid managed care under the Global Commitment to Health, a Section 1115 demonstration waiver. Vermont's umbrella Section 1115 demonstration, in place since 2005 (renewed repeatedly). Under this waiver the Department of Vermont Health Access (DVHA), a unit of state government, operates as the sole comprehensive managed-care-like entity for nearly all Vermont Medicaid enrollees on a global budget, rather than the state contracting with private MCOs. A five-and-a-half-year extension was approved by CMS on June 28, 2022, running through December 31, 2027; recent amendments have added a reentry/justice-involved-population initiative and expanded children's personal care services.
Has Vermont expanded Medicaid under the ACA?
Yes. Vermont has adopted ACA Medicaid expansion. Effective 2014-01-01.
How many people are enrolled in Vermont Medicaid?
Approximately 0.15-0.17M people.
What percentage of the federal Medicaid match does Vermont receive?
59.01% for FFY2026 (Oct 1, 2025 - Sep 30, 2026) — meaning the federal government pays roughly 59 cents of every Vermont Medicaid dollar, and the state pays the rest.
Is most of Vermont Medicaid delivered through managed care?
Estimates range from 0-100% of Medicaid enrollees in managed care.
What Medicaid waivers does Vermont operate under?
Global Commitment to Health, a Section 1115 demonstration waiver. Vermont's umbrella Section 1115 demonstration, in place since 2005 (renewed repeatedly). Under this waiver the Department of Vermont Health Access (DVHA), a unit of state government, operates as the sole comprehensive managed-care-like entity for nearly all Vermont Medicaid enrollees on a global budget, rather than the state contracting with private MCOs. A five-and-a-half-year extension was approved by CMS on June 28, 2022, running through December 31, 2027; recent amendments have added a reentry/justice-involved-population initiative and expanded children's personal care services.
Get Vermont's Free Medicaid Fee Schedule
Request actual Vermont Medicaid reimbursement rates by billing code — free, delivered as a CSV.
Sources
- KFF State Health Facts - Total Monthly Medicaid & CHIP Enrollment
- healthinsurance.org - Medicaid eligibility and enrollment in Vermont
- CMS - Medicaid Managed Care Enrollment and Program Characteristics, 2024
- Federal Register / GovInfo - FY2026 FMAP Notice (89 FR 94742)
- Congressional Research Service - Medicaid's Federal Medical Assistance Percentage (FMAP), Report R43847 (Table, FY2021-FY2026)
- KFF State Health Facts - State Activity Around Expanding Medicaid Under the ACA
- KFF State Health Facts - Managed Care Penetration Rates by Eligibility Group
- CMS Newsroom - Vermont Global Commitment to Health Section 1115 Demonstration Extension Approval
- Vermont Agency of Human Services - Global Commitment to Health 1115 Waiver
Data last verified 2026-09-17. Also see our free Medicaid Fee Schedule tool.