Vermont advocates renew push for single payer system

(The Center Square) — Nearly a decade after then-Vermont Gov. Peter Shumlin nixed a plan for a publicly funded system, advocates have renewed a push to transform health care with a single-payer system.

About 60 House Democrats have signed onto a proposal that calls for eventually replacing private health insurance premiums in the state with a public financing system. This week, supporters of the plan announced the creation of a universal healthcare caucus to push for the approval of the single-payer system. 

The bill’s primary sponsor, Rep. Brian Cina, D-Burlington, said despite efforts to bring down the rate of uninsured Vermonters, thousands of people are still without healthcare coverage. He said those who may be eligible for healthcare plans have “fallen through the holes of a tattered social safety net.”

“It took a mass movement for Vermont to leave the nation by committing to providing healthcare as a public good, not a commodity, it is going to take a mass movement to fulfill the dream and guarantee healthcare as a human right,” he said in a statement.

Cina cited state data showing an estimated 44% of Vermonters under the age of 65 or underinsured and can’t afford the cost of premiums, which increased 7.5% to 14.4% from 2023 to 2024.

Supporters say switching to some form of a single-payer system — also called “Medicare for all” — would curb the state’s skyrocketing health care spending and free up money for other areas of the state budget. They also claim it will help alleviate crushing medical debt.

“Affordability remains one of the greatest barriers for access to healthcare,” he said. “Despite ongoing efforts to expand access to healthcare, it is impossible to control the cost of care in a system designed for the few to profit from the suffering of the many.”

Under a single-payer system, employers and employees would pay the state government through payroll taxes instead of paying premiums to private insurers. Similar to the federal Medicaid program, employees would get a health care card that could be used at hospitals and clinics throughout the state.

The idea has plenty of opposition, notably from the insurance industry, which stands to lose billions of dollars if a single-payer model upends the current health care system.

Other critics say the proposal would add another layer of taxation to a state struggling to remain competitive by reducing the high cost of living. 

Shumlin abandoned the plan in 2014 after projections showed that Vermont would need to raise far more than his administration had expected. At the time, he said the plan would have required a payroll tax of 11.5% and a sliding-scale income tax that would have topped out at 9.5%, which he argued would have upended the state’s economy. 

“Pushing for single payer health care financing when the time isn’t right and it would likely hurt our economy is not good for Vermont and it would not be good for true health care reform,” Shumlin, a Democrat, said in remarks at the time.

“I am not going to undermine the hope of achieving critically important health care reforms for this state by pushing prematurely for single payer when it is not the right time for Vermont.”  

Switching to a single-payer system modeled on health care in Canada and Europe has long been a goal for progressives within the Democratic Party.

In the 1970s, Massachusetts Sen. Ted Kennedy fought unsuccessfully to pass legislation in Congress to create a government-run insurance plan.

President Bill Clinton tried to push through a plan in the late 1990s that would have required private employers to provide insurance coverage for their workers. His proposal, too, fizzled out. 

Vermont Sen. Bernie Sanders has been a longtime advocate of the “single payer” system, which was at the heart of the leftwing agenda that fueled his unexpected rise during the 2016 Democratic presidential primaries.