Mermel Argues Vermont's Universal Primary Care Plan Underestimates Costs
In a letter to VTDigger responding to Olivia Gieger's report on Vermont's universal primary care proposal, financial advisor Myers Mermel argues the plan faces structural and financial obstacles far beyond official estimates. He contends the state's aging physician workforce, with a third over age 60 and 16% planning to leave or cut hours, cannot absorb the demand spike that free primary care would trigger. Mermel estimates actual 2027 costs could range from $400 million to $750 million, well above the state's 2015 projection of $281.9 million, and argues that ERISA preemption of self-insured employer plans and forgone Medicaid waiver funding could push total taxpayer liability to $587 million to $957 million annually. He warns that funding this through a surtax on roughly 3,500 high earners risks taxpayer flight and general fund cannibalization.