Vermont State’s Single-Payer Health Care Law

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Universal healthcare for all, regardless of their level of income and ability to pay for it, has intrigued state legislators all around the USA. People with different views have both criticized and upheld this method of providing medical services to those who need them, but no single state has successfully implemented it. However, the program that Vermont’s legislators attempted to pass has been the closest to success.


People deserve to receive medical aid even if they cannot pay for it because a community forgets no one. Stemming from this rationale, Peter Shumlin, the governor of Vermont, signed the law that initiated the “state-based single-payer system” in 2011 (Liu & Brook, 2017, p. 822). Nonetheless, poor planning, rising costs, and higher taxes stopped Vermont’s desire to provide comprehensive care for all citizens (VerValin, 2017). While considered an overall defeat, Vermont’s Green Mountain Care remains the best example of an attempt at providing universal healthcare.

Adoption of the Reform

While universal healthcare was always the goal of particular activists in Vermont, the needed political situation did not present itself until 2010. Many progressives perceived the proposed Affordable Care Act as a compromise rather than a victory, and the change of governors from Republican to Democrat presented interested parties with the possibility of action (VerValin, 2017). Promptly, the Democrats introduced Bill H 202, which quickly passed with a majority vote, and invited Dr. William Hsiao, a health reform expert who was previously involved in Taiwan’s single-payer switchover (VerValin, 2017).

The creation of a Green Mountain Care Board accompanied the starting part of the plan that was to begin Vermont’s transformation into a state with universal healthcare (Grembowski & Marcus-Smith, 2018). Thus, successfully taking advantage of a change in governors, the single-payer healthcare structure begun its initialization.

Funding Structure

The plan’s shortcomings did not become immediately evident, but when uncovered, demonstrated a single origin for the failure of Vermont’s single-payer health care system. Initially, taxes were not to be raised hugely, with the legislators relying on Medicaid spending to both create a structure for the program and invite more funds from the federal government (VerValin, 2017). This way, people would not lose support for the idea since the increase in taxes would be reasonable, not aiming to cover the full cost of the program. However, all potential progress centered on an internal rise to Vermont’s Medicaid spending, reliant on the growth of its economy.

Consequently, when this part of the plan failed, there was no possibility of ascribing these “enormous costs” to the state’s taxpayers (Grembowski & Marcus-Smith, 2018, p. 183). Since there was no chance to garner enough support for a drastic increase in taxes and no possibility of the Shumlin administration inviting federal backing, the idea of a single-payer system lost its funding.


While Vermont’s single-payer health care law did not succeed, its effect may be considered primarily aimed at educating the state’s current administration on ways to work with the available resources. Learning from the plan’s mistakes, such as the non-inclusion of the administrative cost of Act 48 and the consecutive highballing of the taxes required to carry it out effectively, legislators continued healthcare reform in Vermont (Liu & Brook, 2017).

Following its failure in 2014, the Shumlin administration became more interested in an all-payer model, demonstrating a devotion to what the legislators perceive as a positive change within the system of medical care (Grembowski & Marcus-Smith, 2018). Thus, the single-payer plan allowed the then newly elected Democrats to gain experience on how to work with the public effectively regarding healthcare topics (VerValin, 2017). Therefore, the retracted single-payer plan could not have affected Vermont’s healthcare environment directly but instead may be stimulating coming changes in the state’s legislature.


Attempting to rework the current healthcare system too fast and with many changes, the Democratic administration, along with Shumlin, created the prerequisites for its failures. In a state with a heightened sense of community and civil affinity, single-payer health care could have become a federal trendsetter had it been planned correctly. Nonetheless, the single-payer plan created an undeniable precedent in Vermont’s healthcare system, urging better reforms for the future.


Grembowski, D., & Marcus-Smith, M. (2018). The ten conditions that increased Vermont’s readiness to implement statewide health system transformation. Population Health Management, 21(3), 180-187. Web.

Liu, J. L., & Brook, R. H. (2017). What is single-payer health care? A review of definitions and proposals in the US. Journal of General Internal Medicine, 32(7), 822-831. Web.

VerValin, J. (2017). The rise and fall of Vermont’s single-payer plan. Web.

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NursingBird. (2021, October 8). Vermont State’s Single-Payer Health Care Law. Retrieved from


NursingBird. (2021, October 8). Vermont State’s Single-Payer Health Care Law.

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"Vermont State’s Single-Payer Health Care Law." NursingBird, 8 Oct. 2021,


NursingBird. (2021) 'Vermont State’s Single-Payer Health Care Law'. 8 October.


NursingBird. 2021. "Vermont State’s Single-Payer Health Care Law." October 8, 2021.

1. NursingBird. "Vermont State’s Single-Payer Health Care Law." October 8, 2021.


NursingBird. "Vermont State’s Single-Payer Health Care Law." October 8, 2021.