By: Bob Lucore
This week, the Vermont Senate approved a bill that Governor Peter Shumlin (D) enthusiastically praises as a single-payer plan. Similar legislation was passed recently by the Vermont House, and the Governor is pledges to sign the final bill that will soon emerge.
Vermont’s legislation does not immediately establish a pure single-payer system. Many of the decisions about how the system will work and be funded are still to be settled by a blue-ribbon panel that the legislation establishes. The new system will also require a federal waiver under the Affordable Care Act, and such waivers are not scheduled to take effect until 2017. However, that date may be moved to 2014, if legislative efforts—that have received President Obama’s blessing—succeed.
It is likely that Vermont will become the first state to untangle health coverage from employment and cover everyone under the same plan. All Vermonters will most likely be insured by that state’s Green Mountain Care plan, with most people buying additional supplemental insurance. That would be similar to the system used in France.
State-level activism regarding the Affordable Care Act need not be confined to right-wing lawsuits questioning its constitutionality. As implementation at the national level moves forward, the possibility that other states will follow in Vermont’s footsteps is heartening. In California, for example, a single-payer bill has emerged twice from the legislature in recent years. It was promptly vetoed by Arnold Schwarzenegger both times, but Jerry Brown now occupies that office.
Vermont shows that the story of health care reform in the U.S. is still being written. There is a lot of room for liberal activists to assume authorship of that story.