Vermont has a pending SPA to exercise the Medicaid Health Home option under the ACA to establish the Hub and Spoke model for those with opioid addiction. At the time of this report, state staff were also designing health home models under the Blueprint framework for other populations, including adults with SMI. Another aim of the ACA, to expand the Medicaid-eligible population, is unlikely to influence the Blueprint program. Vermont's Global Commitment to Health, a Section 1115(a) demonstration waiver effective October 2005, enabled the state to achieve universal health care coverage. Vermont staff are, however, attempting to access ACA funding available to other states that are expanding insurance coverage, and to ensure that existing beneficiaries do not lose benefits.