So the governor of Vermont has "admitted" that Vermont cannot afford single payer.
I'm not a bean counter, I don't understand all the reasons how the people of Vermont can't afford to cut their health care bills in half. It's not that simple, there are all sorts of reasons, I get that. It's just that they're all bull. But just because they're all bull doesn't mean they're not real. It just means that we've made such a mess of things that we can't get out without a chainsaw.
So let's break out the chainsaw.
Out of pocket medical expenses are (under conditions) tax deductible. Instead make them a fully refundable credit.
There are reasons why Vermont, or any individual state, cannot do that - they don't have the tax revenue to afford the credits, but the federal government could do it.
And if you like political games, imagine forcing the Republican Party to choose between the insurance companies and the biggest tax cut in human history.