Green Mountain Care cannot start until 2017 because the Affordable Care Act requires states to hew to the federal health reform model for the next three years. This is frustrating for Vermont’s single-payer supporters, who want to put the new system in place sooner.This is the future of America, and Vermont is leading the way.
"When I ran for governor, I had it in my mind...I could find a way to get around it," [Gov. Peter] Shumlin [said]. "My team finally convinced me — and it took some convincing — that it couldn’t be done without losing all our federal funding, which would be suicide. So my goal is to get this done as close to January 1, 2017 as we possibly can."
Republicans fear single payer above all, but ironically, their intransigence on the Affordable Care Act makes it more likely that we'll get to that holy grail of health-care reform.
Had Republicans embraced their Heritage-devised plan, worked with Democrats to best shape it in their mold, then accepted this market-based approach in bipartisan fashion, Obamacare's numbers would look much better. And if overwhelming majorities approved of the plan, any hope of future progress on the issue would be dead in the water. Republicans might not have their ideal (i.e. screw the uninsured), but their CEO buddies would still be living large and they'd still be able to boast of a market-based solution in line with their political ideology.
But with approval of the law still in iffy territory, liberals have room to agitate for further improvements without having to tackle an entrenched and deeply popular law. And with Republicans refusing to allow even minor technical fixes to the law to improve its efficacy, heir continued undermining of the law makes it just as easy in the longer term for liberals to push for bigger and broader chances.
If Republicans wanted to kill any chance of single payer ever happening, the best way to do that would be to ensure that Obamacare was firmly entrenched. Luckily, they have no interest in ever allowing that.