WASHINGTON – A small and progressive state whose legislators are sympathetic to single-payer, Vermont could be slated for a major breakthrough on a goal liberals have vigorously pushed for, but to no avail.


The state's top lawmakers have joined forces and made strides towards implementing a public-only health insurance system, taking up an ambitious idea that could have far-reaching impacts across the country if successful.

Vermont's congressional delegation -- including Sens. Bernie Sanders (I) and Patrick Leahy (D) and lone Rep. Peter Welch (D) -- on Tuesday introduced legislation in both chambers that would allow states to enact their own health care systems in place of last year's sweeping law.

"It is my strong hope that Vermont will lead the nation in a new direction through a Medicare-for-all single-payer approach," said Sanders, a longtime single-payer advocate who last year tried and failed to garner support for the program in Congress.

Vermont's Democratic Gov. Peter Shumlin endorsed the idea, telling Democracy Now he'd like to see a single-payer system in the state by 2014, arguing that "[i]f Vermont can get this right, the other states will follow."

The waivers would exempt states from having to implement the Patient Protection and Affordable Care Act starting 2014, when the crux of it kicks in, as opposed to 2017, when the law would otherwise offer waivers for states to try their own systems instead.

A similar bill was introduced with bipartisan support in November by Sens. Ron Wyden (D-OR) and Scott Brown (R-MA).

"This is a bill to give Vermont and other states the choice to go above and beyond the national standard by letting states devise their own reforms," Leahy said, touting the potential for cost controls.

A single-payer system would eliminate private insurers and create a government-run insurance pool that covers all patients, much like Medicare does for seniors on a national level.

Harvard health care expert William Hsiao, a consultant to the Vermont legislature, concluded in a recent report that an effectively run single-payer program could save the state $2.1 billion in health care costs by 2025.

Such systems drastically lack support in Washington, due in part to the lobbying power of the insurance industry and opponents who argue the private sector is much better equipped to run health insurance than the government.

But the single-payer systems in countries like Canada and England have track records of lower costs and wider coverage, as compared to the mostly private-dominated insurance market in the United States.