Vermont offered help with Single Payer Health Care from President Obama

1 March 2011

President Obama addressed State Governors in Washington D.C. and challenged them to come up with a better health care plan than the Patient Protection and Affordable Care Act, which was passed late last year. Vermont is working on a single payer health care bill.

President Obama said, "If your state can create a plan that covers as many people, as affordably, and as comprehensively as the Affordable Care Act does, without increasing the deficit, you can implement that plan and we will work with you to do it."

Vermont's single payer bill would cover all Vermonters, and is believed to be the most cost effective way to provide comprehensive health care. Vermont's proposal would cover more people and cost less than than the Affordable Care Act. Under the single payer system, all Vermonters would get coverage by 2014, and the state would save 2.1 billion dollars by 2025.

Specifically, the proposal names Vermont's single payer plan Green Mountain Care, and "all Vermont residents shall be eligible for Green Mountain Care" and "An individual may enroll in Green Mountain Care regardless of whether the individual’s employer offers health insurance for which the individual is eligible."

This will be a big benefit to LGBT Vermonters because LGBT couples are disproportionately affected by the current health care system: "20% of same-sex couples have a member who is uninsured compared to 10% of married opposite-sex couples."

President Obama's address to governors is widely thought to be a ploy to diffuse the criticism of the Patient Protection and Affordable Care Act from Republican governors, who are his most likely opponents in the 2012 presidential election. Between Presidents Kennedy and Obama, every person elected to the office had formerly been a state governor. Obama's challenge to them to come up with a plan, that would work better than the health care bill he championed, is designed to end the debate by implying that Obama's plan should not be criticized if a Republican governor (turned presidential candidate) could not create a better system in their own state. And Obama's offer to "work with" the governors on their better plan makes Obama's intentions clear.

Only Vermont and Oregon, both with Democratic governors, are working on health care plans to replace Obama's.



Under the Patient Protection and Affordable Care Act, states are allowed to apply for "State Innovation Waivers" which would allow states to enact and test alternatives to meet the requirements of federal law. The states will get a waiver if their health care laws:
1. Make health insurance affordable and accessible to all Americans in the state
2. Cover those with pre-existing conditions
3. The coverage is at least as comprehensive as the coverage offered through the Affordable Care Act's "exchanges"
4. The coverage is at least as affordable as through the "exchanges"
5. The state proposals do not increase the federal deficit.

President Obama supports accelerating the implementation of the waivers from 2017 to 2014.

As of today, OITM is only aware of two states, Vermont and Oregon, which are seriously working on health care plans that meet the requirements of the "State Innovation Waivers" under the Affordable Care Act.

In addition to VT and OR, Connecticut has introduced Senate Bill 482, which may eventually get a State Innovation Waiver, and Massachusetts Senator Scott Brown has indicated that Massachusetts may begin working on the issue.

Many states are tackling health care issues in ways unrelated to the Affordable Care Act.