Vermont is on its way to establishing the nation’s first single-payer health care system—the proposed national version of which is known as “Medicare for All.” But how the state actually gets there and begins operating the program is unclear, because of some important decisions still to be made.

 

This week, Governor Peter Shumlin signed legislation that calls for taking the first steps in establishing Green Mountain Care, designed to provide universal medical coverage for all Vermonters with the government acting as the central player. The plan is for Green Mountain Care to begin offering coverage in 2017.

 

In the meantime, Shumlin and lawmakers have to figure out to pay for the system. Observers expect the state will propose some kind of tax on individuals and businesses, which would replace having to pay insurance premiums.

 

Politicians have until 2013 to recommend a payment system, and another three years after that to get it adopted into law.

 

While the state would coordinate the program, it will not be the sole provider of medical insurance. The plan is to create a state health benefits exchange that will offer coverage from private insurers, state-sponsored and multi-state plans. The exchange also will include tax credits to make premiums affordable for the uninsured.

 

On the national level, universal health care has proven popular in polls, but, under great pressure from the private health insurance industry, neither major political party has given it serious consideration.

-Noel Brinkerhoff

 

News Coverage Should Reflect That Vermont Has Long Road Ahead to Single-Payer System (by Joanne Kenen, Covering Health)

Health Reform: Timeline (Burlington Free Press)

Vermont Moving Toward Single-Payer Health Care (by Zach Howard, Reuters)

Vermont House Passes Single-Payer Health Care (by Noel Brinkerhoff, AllGov)

4 Political Concepts Ruined by Their Boring Names (by David Wallechinsky, AllGov)