Last month, the Green Mountain Care Board voted to allow Blue Cross to increase its rates for policies sold on Vermont Health Connect by almost 6%. Dr. Allan Ramsay, a member of the board, says Vermont is facing a healthcare affordability crisis that could restrict access to primary care in some parts of the state. He says it's critical for lawmakers to address the "Medicaid cost shift" if it wants to deal with the affordability issue. It's projected that this Medicaid cost shift accounts for roughly 15% of the cost of a private premium. Ramsay says Vermont needs to develop a payment reform system that has roughly the same rates for all of the various payers including Medicaid, Medicare and the private insurance companies.