My sister went to college in Vermont and I remember the people as kind, good-natured, burly and veggie-eating. Who would think that Vermont would be the only state to have started down the path to a single-payer health care system, “using the national health care law as a jumping-off point,” according to Joanne Kenen.
This kind of healthcare is funded by a single insurance pool run by the state and is universal and comprehensive.
“It’s a mistake for our public policymakers to think we can nibble around the broken system,” he told POLITICO in an interview at the Democratic National Convention in Charlotte, N.C. POLITICO reported that he said “he wants change and believes that it’s actually easier to bring big change to little states, which he sees as less beholden than larger states and national politics are to special interests.”
But single-payer are two words you won’t see anywhere in the Affordable Care Act. “Not only did the 2010 health law reject single payer or a public option, its rules and structures prevent a state like Vermont from going single payer, at least at the outset,” Kenen noted.
But as she revealed, this governor is still raring to go.
“This Vermont boy wants to implement that single-payer health care system tomorrow, and I don’t know why you guys want to stop me from doing that,” Shumlin said at a recent POLITICO health policy panel. “It’s the right thing to do. The rest of the world has figured it out. Let’s grow up and join them.”
In May, the governor signed a new health care bill into law that created a health insurance exchange and continued the state’s push toward a single payer health system, according to Bailey McCann.
According to Kenen, the Vermont Legislature and Shumlin’s administration are indeed working on creating a state health insurance exchange under the health care law, noting that it isn’t “single-payer, although it’s often described that way. It’s an exchange. But Vermont is designing its exchange in a way that could be a platform for a state-based single-payer system.”
Shumlin’s argument is that a one-payer system will slow health care spending, freeing up dollars for jobs and economic growth, as Kenen explained.
Other states are hard at work, too. California has already hired 50 employees, with more to come, and the Web portal through which its millions of residents are expected to buy insurance by 2019 is being set up. This fall, the board will seek bids from insurers to sell plans through the exchange, and it intends to have the portal up and running by next summer, several months before enrollment starts in October 2013.
Fifteen states are studying their options, while six states have decided not to create a state exchange. Another fifteen states have already established exchanges, while two states and parts of Wisconsin and Michigan plan for a partnership exchange (which provides oversight to HIXs). The remaining states have no significant plans underway.
Of course, Vermont would have to rethink and quite possibly scrap the whole concept if Mitt Romney were to become president, HHS lands in Republican hands and Republicans repeal the health reform law, Kenen pointed out.
But she added that Shumlin “thinks his plans will grow on Vermonters — particularly as health care providers in a rural state look at the spending and payment trends and decide this is a better way. It’s not sustainable,” Shumlin said of the current system. Without big change, he said, Vermont’s doctors and hospitals “know they are toast,” Kenen quoted him.
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Edited by
Allison Boccamazzo
