The Healthcare Openness and Access Project (HOAP) by Mercatus Center ranked Vermont among the worst states when it comes to health care systems.

Being one of the most restrictive states in the country, Vermont placed 42nd overall in the assessment of the discretion patients and providers have over health care areas. The state also ranked lowest in the area of free-market insurance based on the study.

One of the proponents of the study, Jared Rhoads, blamed the state's over-regulation on the health care sector as the reason for Vermont's bad scores. He said that the result of the study reflects the obsession of state officials for insurance regulations.

"Repealing some of the many state coverage mandates would be a step in the right direction there, although that could be a difficult policy change to get through," Mr. Rhoads commented in an interview with Watchdog.

Through the regulatory power of the Green Mountain Care Board, Vermont has control over aspects of health insurance that are typically covered by regulators in other states. With its strict rule, insurers cannot increase their rates unless approved by the board.

While health system administrators define "access" simply as having an insurance card, Rhoads said that researchers at Mercatus examined a more diverse set of indicators.

"A better way to think about access is to look at what kind of legal or governmental barriers have been erected," he said, adding that the barriers have impact among patients, providers and insurers.

The study also noted that Vermont scored low partly because of the state's certificate of need restrictions. CON laws require the existence of needs in the services to be proven by health care providers.

There have been studies suggesting that such laws actually decrease the quality of care, resulting to higher average of patient deaths compared against other states without the restrictions. Critics also claimed that the laws create hospital monopolies by stifling competition. Other states that do not have a very restrictive regulation on health care were seen to enjoy greater entrepreneurial activities.

However, supporters have insisted that the laws cut costs and ensure the quality of health care.

The results also showed that Vermont ranked 44th on pharmaceutical regulations, with its prescription monitoring system said to be inefficient and outdated.

The study also noted on the aspects where Vermont was said to perform well, including its recent deregulation of naloxone, as well as the ability to use telemedicine, an area where the state ranked third.