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Vermont lawmakers are seeking to implement new oversight measures on hospitals and limit how much they could charge for care, proposals that would significantly change how the state’s largest health care providers can operate. 
The Legislature’s health care committees each voted by wide margins Friday to advance bills that would bolster the Green Mountain Care Board, a health care regulator, and strengthen its ability to oversee prices, obtain data and make changes to hospital governance.
Broadly speaking, the two bills represent an effort to rein in costs, increase financial transparency and shore up Vermont’s shaky health care institutions, Sen. Ginny Lyons, D-Chittenden Southeast, the chair of the Senate Committee on Health and Welfare, said in an interview Friday.
“The most important thing is we’re trying to get out of the health care crisis that we’re in,” Lyons said.
Many of Vermont’s health care entities are struggling to make ends meet, and patients are facing rising costs and long waiting lists.
The bills also reflect what Vermont’s Chief Health Care Advocate Mike Fisher described as an increasing concern about the University of Vermont Health Network’s role in the state health care ecosystem.
As costs rise and health care institutions become increasingly fragile, the network has drawn scrutiny and criticism recently for cutting services, moving money between Vermont and New York hospitals and paying out several million dollars in executive bonuses. 
“I hear a great deal of skepticism from legislators about the way money is flowing through the health network, and about its impact on the health care system,” Fisher said. “And I think that’s apparent by the language that’s being considered.”
Annie Mackin, a spokesperson for the University of Vermont Health Network, said in an email that “Vermont has the most transparent and rigorously regulated nonprofit health care system in the country.”
The network also shares “the goal of making health care more affordable, and (recognizes) we are in an access and an affordability crisis,” she said.
The sprawling Senate bill, 32 pages in its most recent draft, directs the Care Board to implement reference-based pricing, a cost-saving model in which the prices that hospitals charge private insurance companies are pegged to Medicare rates. 
It would also direct state officials and health care leaders to draft a “statewide health care delivery plan” by 2029, including overall care goals, projected costs and resource allocations for Vermont’s health care system — and would allow the board to “correct any aspect of the structure of a hospital network or its financial operations” that does not align with that plan. 
The bill would also require hospitals to submit more financial information to the Green Mountain Care Board and would compel hospitals to inform state officials and lawmakers before reducing or cutting services to comply with their budgets. 
And the legislation would compel the board to scrutinize hospital executive salaries and bonuses and compare them to those of practitioners — provisions that come in the wake of news that UVM Health Network executives received $3 million in bonuses while cutting patient services last year. 
Lyons, the Senate health committee chair, said Friday that she and other lawmakers were concerned about some of the network’s prices and financial practices. 
“We want to begin to build a system that has greater fairness across the board, and that offers sustainability for providers, and will help patients be able to access the care they need,” she said. 
In testimony in the Senate this week, Devon Green, an in-house lobbyist for the Vermont Association of Hospitals and Health Systems, expressed support for some payment reforms, but said the organization would still need more information about the plans.
She also opposed some provisions that bolster the Green Mountain Care Board’s mandate to obtain data from hospitals. In some cases, she noted, hospitals are already required to provide such information to the board — and in others, she said, the language in the bill would give the board ill-defined and overbroad powers. 
“There are some initiatives like the work we are doing together to find a path forward on reference-based pricing that we view as progress,” Green said in an email Friday. “There are of course other aspects of these pieces of legislation that we remain concerned with. We will continue working with lawmakers, the Green Mountain Care Board, AHS and others to further strengthen these bills.”
The shorter House bill would allow the board to reduce the reimbursement rates paid out by an insurer to hospitals if the insurer “faces an acute and immediate threat to its solvency.” That new power would only apply to hospitals or networks with positive operating margins and 135 days’ cash on hand. 
Last week, Vermont’s largest private insurer, Blue Cross Blue Shield, announced that it lost $62 million in 2024. That was the largest yearly deficit in three straight years of losses, Blue Cross administrators said, reflecting a 15.5% increase in its costs for claims over the previous year.
That will likely mean more double-digit increases in premiums for 2026, Sara Teachout, an in-house lobbyist for Blue Cross, said in a media call last week. 
The bill would also allow the board to appoint an outside observer if it found that a hospital had “made a material misrepresentation” to the board or was “materially noncompliant” with a budget order.
Rep. Alyssa Black, D-Essex, the chair of the House Committee on Health Care, said that the legislation was “in response to a crisis that we are in at this very moment” in a brief interview Friday.
“What motivated it was the very real insolvency of the only health insurance domiciled in Vermont,” Black said. 
Mike Del Trecco, the president and CEO of the Vermont Association of Hospitals and Health Systems, told House lawmakers Friday morning that he “can’t support” their bill.  
“I deeply understand the gravity of the issues and the fragile nature of our delivery system, along with the affordability issues that we face, and I can assure you that our hospitals are working on these issues deeply,” Del Trecco said. 
Reducing reimbursement rates, however, would effectively pull money from hospitals — and, Del Trecco said, “if we take it just from one source, we’re going to create a situation where we may put hospitals into jeopardy of failing and closing.” 
But Owen Foster, the chair of the Green Mountain Care Board, told House lawmakers Friday morning that their legislation was a crucial tool in shoring up the state’s health care system. 
“Vermont right now is like one big gigantic dysfunctional family that used to be wealthy, and now is not,” Foster told the committee Friday morning. “And we have real problems.”
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The largest NLRB union election win in February was at the primary care group Optum Care, a subsidiary of UnitedHealthcare. The vertical integration of health care has brought frustrating consequences for health workers, who are now organizing in response.
Hundreds of 1199SEIU health care workers stage a rally and march in New York on March 29, 2023. (Lev Radin / Pacific Press / LightRocket via Getty Images)
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In this monthly roundup on “large-unit labor elections,” Benjamin Y. Fong from the Center for Work and Democracy at Arizona State University will recap all National Labor Relations Board (NLRB) elections of 250 or more voters tallied in the previous month, in this case for February 2025. See the January 2025 roundup here.
It’s the center’s belief that if the labor movement in the United States is to be rebuilt, it is going to be through experimentation with new strategies and tactics that push against the constraints of labor law and through large-unit organizing in the hundreds and thousands. The latter concern will be at issue in this series.
Given the outsize importance of large-unit labor elections in the overall composition of the labor movement, there’s a good argument to be made that the overall trajectory of organized labor can be gleaned from an analysis of such elections.
There were 122 National Labor Relations Board representation elections run in February 2025, and ten involved units of 250 or more eligible voters. Those ten elections, however, involved 74 percent of all eligible voters that month.
The highest-profile election was the loss at the Amazon Fulfillment Center in Garner, North Carolina, which my colleague Jonathan Rosenblum covers well here. Jonathan and I offer some more in-depth thoughts on what recent news in the world of Amazon organizing means in a recent article in these pages, but in brief: it’s going to be very difficult to make much headway with this company with traditional site-by-site organizing methods. Amazon is too big and too flexible for such organizing, and the company is only going to come to the table if the flow of goods through their dynamic distributional system is disrupted, which requires multisite coordination and a laser focus on the pain points in their facility network.
As with last month, health care elections dominated the large-unit news, claiming five of the eight large-unit victories. The other victories included an undergraduate workers’ union at Macalester College (1,098 workers), transportation workers at Zum in Jessup, Maryland, joining Teamsters Local 570 (300 workers), and transportation workers at Unifi Aviation in Georgia doing the same with the National Association of Government Employees (356 workers).
The largest unit won in February was for 1,120 nonprofessional workers at an Optum Care subsidiary, Crystal Run Healthcare, a network of eleven primary care facilities in the state of New York. Optum is in turn owned by UnitedHealthcare, which gained massive international attention after the murder of its CEO, Brian Thompson, in December 2024 and is now the largest employer of doctors in the United States.
It’s worth repeating: the largest health insurance company in the country is also the largest employer of doctors. Amy Gladstein, assistant for strategic organizing at the union that organized Optum, 1199SEIU United Healthcare Workers East, cited this “vertical integration of health care” as the driving force behind the organizing effort.
From the perspective of UnitedHealthcare, it makes sense to own the very primary care practices that they’re also reimbursing: cutting costs in the former means less expenditure in the latter. From both patients’ and workers’ perspectives, however, this vertical integration is extremely frustrating, depressing wages and benefits and depersonalizing care. And what’s happening at Optum is occurring in primary care across the country, from Amazon’s One Medical to Walgreens’s VillageMD.
One particular frustration felt by both workers and patients was the establishment of a call center: instead of getting direct lines to offices or departments, patients were directed to a general call center number where they would sometimes wait so long that they’d just give up on booking an appointment or doing follow-up. Some workers got in trouble when they’d give out direct lines or their personal numbers to patients.
As important as wages and benefits are to these workers, this basic breakdown in the provision of care was a key frustration for Optum workers. Gladstein noted that while the lingering effects of the COVID-19 pandemic were a primary source of organizing among hospital workers, it was frustrations like these, stemming from the corporatization of primary care, that fueled organizing efforts like that of Optum workers:
In hospital organizing, it was COVID and feeling unrecognized in staffing. In this organizing, it is the corporatization of health care. I think it comes from a different place. [Traditionally] if you’re working in a primary care practice, you know how to find the doctor, and the doctor isn’t being squeezed into twenty-minute blocks. And then, all of a sudden, you’re under this other set of rules, and [they’re written by] a big corporation that makes billions. So it’s a different set of issues that draw people toward us.
Optum has run an intense anti-union campaign and even has an in-house, anti-union management team euphemistically dubbed “the People Team.” After the successful representation election, where the union won by a two-to-one margin, Optum announced its intention to challenge the results, on the grounds that 1) since the NLRB did not have quorum, it could not certify elections and 2) that the company was not able to exercise its free speech rights by holding captive audience meetings, which were banned in the waning days of Joe Biden’s NLRB.
The first objection, now made irrelevant by the fact that Gwynne Wilcox has been reinstated as an NLRB board member, never held up, as the board has the ability to process elections at the regional level even while lacking the ability to decide cases, according to a 2010 Supreme Court case. The second objection, that depriving a company of the ability to hold mandatory meetings is an infringement upon its free speech rights, is about as twisted an understanding of the First Amendment as you’re going to find.
The Oregon Nurses Association (ONA) won three large units at the Legacy hospital system in Portland, Oregon, totaling 2,298 nurses. ONA actually filed for these units together, and the board stipulated that the elections be run separately, so arguably this was the de facto largest unit won in February.
Elizabeth Gemeroy, deputy director of organizing at ONA, cited the alleged normalization of practices during the COVID-19 pandemic as a key spur to organizing:
COVID really just exacerbated all issues in health care. During COVID, staffing [i.e., the staffing ratios of number of nurses to number of patients] was horrible, because we were trying to stop the spread. All of the protections went away because we were in a crisis situation. And management was like, “Oh, we made a lot more money when we were in crisis, because there were a lot more people who came into the hospital and a lot fewer staff.” And it seems like that’s now the model.
As with Optum workers, Legacy nurses also felt the impingements of the corporatization of health care:
There was a huge lack of transparency from their employer. This is a trend with the corporatization of health care: there’s so many managers, and your direct manager working on the floor [is answering to someone else] who’s making decisions about patient care, [and they’re] not even in the hospital. They’re probably states away. They probably have a degree in business, and they’re generally making decisions based on spreadsheets, not based on patient care, patient outcomes, or best practices.
This alleged lack of transparency was also felt in pay disparities and what many nurses felt to be a lack of recognition of seniority. More generally, knowing what their equivalents made at other hospitals, nurses at the Legacy hospitals simply felt they were underpaid as a whole.
The organizing drive started with the formation of Legacy Frontline Workers, a grassroots group that started a petition against Legacy’s COVID practices in 2021. ONA started working with three different groups of workers at the three different facilities at that time, but eventually they ended up combining organizing committees, as nurses from different hospitals were happy to work together as part of a broader effort. This proved a fortuitous decision when it was announced in October 2024 that the Oregon Health & Science University (OHSU) bought Legacy’s facilities. ONA already had a strong foothold at OHSU hospitals, whereas Legacy had been much more hostile to unionization.
This announcement energized the organizing efforts, and all three facilities filed for an election at the same time. According to Gemeroy, the units made a conscious decision to wait until all three were ready to file, understanding the importance of the solidarity that had been built through the system-wide organizing committee.
ONA has a set program for building organizing committees and ensuring wins in NLRB elections, executed in collaboration with nurse leaders. But Gemeroy said that they slightly changed their practices to accommodate such a large unit of workers. Typically, they would hope to form an organizing committee comprising roughly 10 percent of the total unit, achieving a leader-to-worker ratio of one to ten. In this case, that would have meant an organizing committee of about 230 workers. To maintain a tenable decision-making body, they kept the organizing committee around seventy nurses and trained an additional layer of about 140 nurse organizers to be election captains, thus allowing for an extension of organizing structure without impeding decision-making.
Both Gladstein and Gemeroy were concerned about larger political dynamics around looming disruptions to the NLRB process but didn’t feel like they were going to impede new organizing efforts. If anything, Gemeroy believes that a more hostile political environment will “invigorate more folks to move to organizing.” The February total election count was not out of line with that of previous years, so any cooling of labor organizing interest with the new Trump administration has yet to be registered.
Benjamin Y. Fong is associate director of the Center for Work and Democracy at Arizona State University. He has a Substack focusing on labor and logistics called On the Seams.
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There were 122 National Labor Relations Board representation elections run in February 2025, and ten involved units of 250 or more eligible voters. Those ten elections, however, involved 74 percent of all eligible voters that month. The highest-profile election was the loss at the Amazon Fulfillment Center in Garner, North Carolina, which my colleague Jonathan […]
There were 122 National Labor Relations Board representation elections run in February 2025, and ten involved units of 250 or more eligible voters. Those ten elections, however, involved 74 percent of all eligible voters that month. The highest-profile election was the loss at the Amazon Fulfillment Center in Garner, North Carolina, which my colleague Jonathan […]
There were 122 National Labor Relations Board representation elections run in February 2025, and ten involved units of 250 or more eligible voters. Those ten elections, however, involved 74 percent of all eligible voters that month. The highest-profile election was the loss at the Amazon Fulfillment Center in Garner, North Carolina, which my colleague Jonathan […]
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When lifting weights, a good rule is resting for 48 hours of recovery time per muscle group, fitness experts say.
If you ever turned on the TV in the 2000s after midnight, you might have seen an infomercial for P90X.
It promised shredded abs and bulging biceps for anyone who pushed themselves to their limits for 90 days of 60-minute workouts. So it may come as a surprise that its creator, Tony Horton, now preaches the benefits of rest and warns against overtraining.
“I didn’t know then what I know now,” says Horton, who had spent the ’90s training celebrities. “Back then it was all about warmups and cooldowns, and telling them to eat better and get off the hooch.”
His evolution reflects a broader shift in the exercise industry away from a “no pain, no gain” mentality that once dominated but often led to injury. Instead, the current buzzword in fitness is “recovery.”
Horton — who at 66 still exudes a boyish exuberance — notes that P90X did include recovery days with stretching and low-impact movement such as yoga. But these days, he prioritizes mindfulness as much as exercise, and the time between workouts is filled with plenty of good sleep, plunges in frigid water baths, using foam rollers on tight muscles, relaxing in a sauna and other activities in the name of recovery.
“If you don’t get the recovery and the rest part right, then you’re never going to be able to be consistent with the fitness end of things,” Horton says.
More holistic approach
Before Horton, Jane Fonda had pushed home exercisers to “feel the burn,” while bodybuilders lifted weights to the point of muscle failure. Now, the American College of Sports Medicine and the National Academy of Sports Medicine, two of the largest organizations certifying personal trainers, emphasize recovery methods.
NASM’s Fitness and Wellness certification includes training in “holistic health and wellness including physical, mental, social and emotional well-being.”
The industry has learned from research that shows the benefit of proper rest, says Stan Kravchenko, founder of the OneFit personal training platform. During deep sleep, the body repairs muscle tissue, and studies show that well-rested people perform better and are less likely to get injured.
But rest is only part of recovery. Kravchenko says trainers used to focus only on specific exercises a client could do during their workout. Now, they’re more like life coaches who also give exercise advice.
“It’s more about your lifestyle, how you eat, how you sleep,” he says. “Are you stressed? What do you do for living? Are you working from a desk? So it’s taking a little bit more broad approach.”
Discomfort, not pain
The “no pain, no gain” motto is great for athletes who can handle intense workouts and are looking to get stronger, but not everyone needs to push themselves that hard, Horton maintains. It depends on the goal.
Michael Zourdos, chair of exercise science and health promotion at Florida Atlantic University, says lifting weights “until failure” may build bigger muscles, but isn’t needed to increase strength. “There is a difference between training for health and training for elite performance benefits,” he says.
To realize the health benefits of a workout, it’s still necessary to push yourself, Horton says: “In the muscles, the lungs, your heart, there’s gotta be a certain amount of strain.”
There is a big difference, however, between discomfort and acute pain. If discomfort crosses into sharp pain in joints, tendons or muscles, stop that movement.
How much rest?
People’s needs vary depending on their goals and bodies. But Kravchencko offers a few general guidelines:
For lifting weights, he recommends allowing 48 hours of recovery time per muscle group, and doing a maximum of 10 sets per muscle group per week. During the workout, he says, it’s best to rest for two to three minutes between sets, as opposed to old advice to wait only a minute before exercising the same muscles.
In between workouts, it’s not necessary to stay still.
“You’re welcome to do walking, jogging, very light yoga, stretching, pilates, core exercises,” Kravchencko says. “That’s all fine, because it’s not specifically targeting the areas you’ve targeted before.”
Mindfulness as recovery
Horton and Kravchencko both mentioned a recovery practice not typically associated with weightlifting — meditation. Taking a few quiet minutes every morning helps you deal with the physical and emotional stress of life that can get in the way of wanting to exercise, they said.
Horton recommends establishing a mindfulness routine even before formalizing an exercise plan because it will lay the groundwork to be consistent.
“What is your strategy to get to get healthy and to get fit and to stay that way?” he says. “A lot of it has to do with letting the pendulum swing the other way.”
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Measles case confirmed in southwest Kansas for first time in 7 years, health officials say  Kansas City Star
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Sandra Hernandez holds a “Don’t Take Away Our Health Care” protest sign outside the U.S. Capitol as the Senate voted on a “Skinny Repeal” of the Affordable Care Act inside on July 27, 2017 in Washington, D.C. The measure did not pass. (Alex Edelman/ZUma Press/TNS) Alex Edelman
By JAYME H. SIMÕES
Jayme H. Simões is a communications professional at Louis Karno & Co. in Concord who has advised numerous public policy and nonprofit organizations.

Fifteen years ago, the Affordable Care Act (ACA) was signed into law by President Barack Obama, marking one of the most consequential health care reforms in American history. As someone who worked on its launch and helped lead public outreach efforts in New Hampshire, I have seen firsthand how the ACA has transformed our lives.
The ACA has expanded coverage for millions, lowered premiums and out-of-pocket costs and helped take New Hampshire’s uninsured rate to an all-time low. I should know: My family gets our coverage through the ACA.
For more than 100 million Americans with pre-existing conditions, the ACA guarantees protections against discrimination by insurance companies, ensuring they are not charged more or denied coverage. More than 150 million Americans now receive no-cost preventive care, and young adults can stay on their parents’ plans until age 26. Most importantly, a record 24.2 million Americans are now enrolled in ACA Marketplace coverage, thanks to tax credits that have made health insurance more affordable for middle-class families.
These tax credits have provided vital financial relief, helping families afford not just health care, but also essentials like rent, groceries, and gas. Health care should never be a luxury — it is a necessity. The ACA has made it possible for many people to seek medical care without the fear of financial ruin or going without treatment altogether.
When the ACA was first implemented, I worked with Louis Karno & Company to ensure that New Hampshire families knew their options under the law. Through Covering New Hampshire, we launched a statewide campaign to educate uninsured residents about their new health care choices and financial assistance available through the Marketplace. We used a comprehensive outreach strategy, from the CoveringNewHampshire.gov website to digital ads, direct mail campaigns, radio and TV broadcasts. We shared stories of real Granite Staters who gained coverage through the ACA, making it clear how these policies impact lives.
Over the last 15 years, the ACA has helped stabilize health insurance markets, strengthen protections for patients, and improve health outcomes across the country. It has been especially beneficial in rural communities, where access to affordable health care is often limited. Many rural hospitals and clinics rely on Medicaid expansion, a key provision of the ACA, to remain open and continue serving their communities. Without it, hospitals in underserved areas would be at risk of closure, and patients would be forced to travel long distances for care.
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The economic benefits of the ACA cannot be overlooked today. By lowering the number of uninsured individuals, the ACA has helped reduce uncompensated care costs that burden hospitals and drive up expenses for everyone. It has also provided financial security to millions of families who no longer have to worry about being denied coverage due to a pre-existing condition or reaching a lifetime cap on their benefits.
Despite the ACA’s success, challenges remain. While enrollment has reached record highs, millions of Americans still lack access to affordable health care. Continued efforts are needed to ensure that coverage remains accessible, affordable and responsive to the needs of working families, small business owners and young adults.
Worse, some in Congress want to end the tax credits, others want to end Medicaid Expansion and some want to end the ACA altogether. Millions of Americans like me rely on these tax credits, but some want to take them away, which would lead premiums to spike and leave 5 million more people uninsured.
As the ACA turns 15, it is worth reflecting on how far we’ve come and the work that still needs to be done. Health care reform does not end with one law; it requires continued improvements, investments in public health and policies that put people first. The ACA has shown that when we expand access to affordable health care, we strengthen our economy, improve public health and give millions of Americans the security and dignity they deserve.
Fifteen years later, the ACA remains a lifeline for millions. Now is the time to secure its success and ensure that every American has access to the care they need — today, tomorrow and for generations to come. Congress needs to act now.

03-13-2025 1:02 PM
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UnitedHealthcare hires local police to tighten security after Brian Thompson shooting  Irish Star
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ALTOONA, Pa. (WPVI) — Luigi Mangione's attorney in Pennsylvania is seeking to dismiss the charges against him in the commonwealth.
Mangione was arrested at a McDonald's, just days after he allegedly shot and killed the CEO of UnitedHealthcare in New York City late last year.
Mangione faces firearm and forgery charges in connection to the 3D printed firearm and false ID that were allegedly in his possession at the time of his arrest.
RELATED: Luigi Mangione, accused killer of UnitedHealthcare CEO Brian Thompson, issues statement from prison
In a court filing Wednesday, his attorney says those charges should be dismissed because Mangione was illegally detained, arrested and searched at the restaurant.
The attorney claims Mangione was not positively identified as the suspect until after he was arrested.
The filing also states the attorney is asking the court to prohibit prosecutors from calling Mangione's recovered writings a manifesto.
He says that description could prejudice a jury should the case go to trial.
RELATED: Luigi Mangione's defense cites evidence concerns, no trial date set
The 26-year-old also faces charges in New York.
He has pleaded not guilty to state charges there.
He has yet to enter a plea tied to federal murder charges he faces.

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