Vermont’s top health care regulator is stepping down after cost-control battles

Owen Foster will step down as chair of Vermont’s Green Mountain Care Board at the end of September 2026, but he plans to remain on the five-member board as a regular member.

The leadership change comes as the board prepares to begin its next hospital-budget review on Aug. 3 and continues reviewing proposed 2027 Affordable Care Act marketplace rates for BlueCross BlueShield of Vermont and MVP. Those proceedings can affect hospital finances, insurance premiums and costs paid by Vermonters, employers and families.

What changes — and what does not

Foster told VTDigger that the decision was his own. He said he wants to spend more time with his children and focus on other professional pursuits.

He is not leaving the Green Mountain Care Board entirely. Foster is expected to continue serving as one of the four regular members, and he plans to remain chair through the hospital-budget process that begins Aug. 3 and runs into September.

That distinction matters because the chair has general charge of the board’s offices and employees, while the board’s regulatory decisions are made by the members collectively. Foster’s continued membership means he is expected to retain a vote after leaving the chair position. The state had not announced a successor as of Aug. 2, 2026.

Hospital budgets and insurance rates remain active

The Green Mountain Care Board approves annual hospital budgets and reviews health-insurance rate changes, among other duties. Vermont law establishes the board as a chair and four members and gives the chair administrative responsibility for the board’s offices and employees.

The next hospital-budget review is scheduled to start Aug. 3. The board also is reviewing proposed 2027 marketplace rates filed by BlueCross BlueShield of Vermont and MVP. Those reviews are ongoing; no final rate decision is described here as complete.

For Vermonters who buy individual or small-group coverage, the rate proceeding could affect future premiums. Hospitals and insurers are also watching the board because its decisions influence annual budgets, reimbursement pressure and the amount of health care spending passed through to payers.

Foster recused himself from the BlueCross BlueShield rate review, citing personal reasons. He has not publicly provided more detail, and the recusal should not be treated as evidence of a particular underlying cause.

A tougher focus on spending

Foster’s tenure was marked by closer scrutiny of hospital budget growth, insurance premium increases and health care administrative spending.

He also emphasized shifting services that do not require a hospital setting — such as some outpatient surgeries, imaging and laboratory work — into less-expensive settings. The broader goal was to direct more health care dollars toward patient care and primary care rather than administration, according to Foster’s account to VTDigger.

Vermont Public reported in March that regulators were continuing to press hospitals to reduce costs as the state’s health care system faced financial strain. That context helps explain why the chair transition is being watched by hospitals, insurers and residents, but Foster’s departure itself does not establish the cause of those financial conditions.

How a successor will be chosen

Vermont law does not give the governor sole authority to select the next chair. The Green Mountain Care Board Nominating Committee is created to nominate the chair and board members. The committee has nine members: appointees of the governor, the Senate and the House, including legislative members from both major parties and three members appointed for health care policy, delivery or financing expertise.

Under 18 V.S.A. § 9391, the committee selects qualified candidates and submits their names to the governor. The governor then makes the appointment, which is subject to Senate consent. The process is separate from Foster’s continued service as a regular board member.

For a known vacancy, the committee generally must begin its application process no later than 90 days before the vacancy. The law also directs a member who plans to leave before the end of a term to notify the committee chair, governor and Department of Human Resources.

What residents should watch next

• Aug. 3, 2026: The next hospital-budget review is scheduled to begin.
• Through September: Foster is expected to remain chair during the hospital-budget process.
• 2027 marketplace rates: The board’s reviews of BlueCross BlueShield of Vermont and MVP remain pending.
• End of September: Foster is scheduled to leave the chair position while remaining a board member.
• Succession announcements: The nominating committee, governor and Senate will follow the statutory nomination, appointment and confirmation process for the next chair.

The immediate question is not whether Vermont’s health care regulator will continue operating. It is how much continuity the board will maintain while it makes decisions that can affect hospital budgets, insurance affordability and the direction of cost-control efforts across the state.

Sources

• Owen Foster stepping down as chair of state’s most powerful healthcare regulator
• Regulators signal they aren’t done asking hospitals to cut costs
• 18 V.S.A. § 9374 — Board membership; authority

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