New Vermont Law Sets State On Course For Universal Health Care

This morning, Vermont Governor Peter Shumlin signed into law a groundbreaking health care bill that puts his state on a path towards universal coverage for all residents. The legislation, H.202, sets Vermont on course to become the first state in the nation to implement a single-payer system, and had previously passed both the House and Senate chambers by significant margins. At the signing ceremony, Gov. Shumlin commented on the historic nature of the legislation, and the increased benefits it promises to bring to the Green Mountain State:

"We gather here today to launch the first single-payer health care system in America, to do in Vermont what has taken too long — have a health care system that is the best in the world, that treats health care as a right and not a privilege, where health care follows the individual, isn't required by an employer — that's a huge jobs creator."

Dr. Deb Richter, a single-payer advocate who attended the bill signing, warned in comments to the Associated Press that, "we're going to hear all kinds of scare stories that this is a thoughtless experiment or that it is too bold. But I would remind you that every other industrialized country is doing what we are trying to do. And they do it for far less money, they live longer and they get better-quality care."

One key piece of the legislation is the enactment of the Vermont Health Benefit Exchange, which will serve as the marketplace for consumers provided for under the Affordable Care Act until the enactment of a state-based single-payer system scheduled for 2017.

Community Catalyst's Health Policy Hub provides a great breakdown of the exchange and other key provisions of the Vermont bill signed into law today:

  • Vermont Health Benefit Exchange: The Exchange — established as a division within the Vermont Department of Health Access (the state Medicaid agency) — will facilitate purchase of affordable, qualified health plans in the individual and group markets and will meet all other requirements specified in the ACA for state Exchanges. Upon the implementation of Green Mountain Care (the name for the new single-payer system), the Vermont Health Benefit Exchange will cease operation.

  • Green Mountain Care: Upon receipt of the necessary federal waivers and approval of a financing plan by the legislature, Green Mountain Care will be implemented to provide comprehensive, affordable, high-quality, and publicly financed health care coverage for all Vermont residents. Assuming that the necessary waivers are granted, the federal funding previously provided in the form of premium tax credits, cost-sharing subsidies, and small business tax credits under the ACA would be used to partially finance Green Mountain Care. The state will also seek to use Medicare, Medicaid, and CHIP funds as a financing mechanism.

  • Green Mountain Care Board: A board will also be created to oversee the development and implementation of health care payment and delivery system reforms designed to control health care costs and maintain health care quality in Vermont. The board will have five members, nominated by a new Green Mountain Care Nominating Committee and appointed by the governor with the consent of the Senate.

The approval of a state-based exchange in Vermont follows the recent passage of legislation creating exchanges in Washington state and Colorado, both with bipartisan support.