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Vermont Department of Health - Rural Health and Primary Care

% of surveyed adult patients who have health insurance coverage 90+ days after their first visit at a Free Clinic

Current Value


HY2 2019


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Story Behind the Curve

The percentage of previously uninsured adult patients who have maintained their health insurance coverage 3 to 6 months after enrolling with help from VCCU member free clinics dropped rose from 75% in 2015 to a high of 99% in 2017, but has since dropped off to 47% in 2019. This can be attributed to a number of factors, including the VCCU losing capacity for their insurance navigator positions. (Source: VCCU semi-annual grant report).

Each year VCCU clinics survey a portion of their patients at least 90 days after their first visit to see how many have maintained their new insurance coverage after initial enrollment. 

Our goal for 2020 is to have 100% of Vermonters with adequate health insurance so they will not be faced with significant out-of-pocket expenses when seeking health care. In 2010, only 9% of Vermonters were uninsured, compared to 16.8% nationally (2008, HP2020 goals). Many more were under-insured with only catastrophic health insurance coverage.


Vermont Coalition of Clinics for the Uninsured (VCCU) and their member free clinics:

Bennington Free Clinic, (Bennington)

Good Neighbor Health Clinic (White River Junction)

Red Logan Dental Clinic (White River Junction)

The Open Door Clinic (Middlebury)

Rutland Free Clinic & Dental Clinic (Rutland)

People's Health & Wellness Clinic (Barre)

Putney Walk-in Clinic (Putney)

The Health Assistance Program at FAHC (Burlington)

Health Connections at Gifford (Randolph)

Valley Health Connections (Springfield)

Windsor Community Clinic (Windsor)

What Works

Having adequate health insurance can reduce barriers to quality health care, and may even improve an individual’s health. A key component of the Affordable Care Act (Obamacare) is that anyone with an insurance plan is now guaranteed access to many preventive services that were rarely covered under catastrophic health insurance plans of the past and very expensive if paid out of pocket.

A study of health outcomes after implementation of health care reform in Massachusetts, including health insurance mandate, found improvements in general health (1.7%), physical health (1.3%) and mental health (1.5%) among 345,000+ respondents. Significant improvements were also noted in the rates of preventive services like Pap smears (2.3%), colonoscopies (5.5%) and cholesterol testing (1.4%). Changes in health status were greater among lower income households (<300% FPL). (van der Wees, P.J., et al, Improvements in Health Status after Massachusetts Health Care Reform, The Milbank Quarterly, Vol. 91, No. 4, 2013 (pp. 663–689) Mass_Health_Care_Reform_Study.pdf

The Medicaid expansion and Vermont Health Connect has helped increase insurance coverage across income levels. Despite the largest decline in uninsured rates between 2012 and 2014 (6.9%) the adults at 100%-199% by annual family income - FPL still have the highest rate of uninsurance (5.3%). Mass_Health_Care_Reform_Study.pdf

Action Plan

VDH’s State Office of Rural Health & Primary Care will share this information and continue to work with VCCU member clinics and FQHCs to increase enrollment and uninsured residents in Essex, Caledonia, Lamoille, Windsor & Windham counties. We will identify potential interventions to increase enrollments and to maintain enrollment over the next several years.

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