VT Governor Signs Single-Payer Bill

Gov. Peter Shumlin (D) has signed into law  bill H202, which could make Vermont the first state in the nation with a single payer health insurance system. All of the state's more than 600,000 residents will qualify for the program called Green Mountain Care.

In a press statement Gov. Shumlin said the bill confirms that "we can reduce cost growth without compromising health care quality, but it will take a new approach – we can't simply cut provider fees."

Just as importantly, he added, "We have a moral imperative to fix this problem, with 47,000 Vermonters uninsured and another 150,000 underinsured and worried about how to afford keeping their families healthy."

The law states that federal waivers must be received to create the single-payer system.

The 213-page law presents a grab bag of reform measures, including:

• Establish a state healthcare board to ensure cost-containment in healthcare, create system-wide budgets, and pursue payment reform
• Establish a health benefit exchange for Vermont as required under federal health care reform laws
• Create a public–private single-payer healthcare system to provide coverage for all Vermonters
• Create a consumer and healthcare professional advisory board
• Examine reforms to Vermont's medical malpractice system
• Modify the insurance rate review process
• Create a statewide drug formulary

The law calls for a healthcare board to will be appointed by the governor and be in place by October 2011. It will have the authority to control the rate of growth in the cost health insurance premiums as well as healthcare provider payments. The board will work with physicians and other providers to eliminate fee-for-service medicine and to establish incentives for improving the health of their patients.

How the law will be funded remains a question mark. Gov. Shumlin acknowledged in his press statement that "people have legitimate questions about how a single payer will be financed and operated, and we will answer those questions before the legislature takes the next step."

 "We'll be getting input from all Vermonters moving forward, which is essential to the success of this effort," the Governor said. "But input from providers, businesses, and healthcare consumers will be especially important to assuring that our reforms are good for our health care system and good for our economy."