Vermont Gov. Peter Shumlin has unveiled legislation that would create the nation's first single-payer health insurance system by abolishing most forms of private health insurance and moving state residents into a publicly-funded insurance pool.
The bill would move the state through three stages to reach the target of a single-payer system. The first part of the plan would include setting up a health insurance exchange like the system envisioned under the health reform law. But instead of the multiple exchanges many other states are planning, Vermont would have just one covering the entire state population, NECN reports.
A new, independent Vermont Health Reform Board proposed to begin work later this year would be charged with developing ways to reform how doctors and hospitals are paid and setting budgets for health expenditures, according to the Burlington Free Press. The intent was to move away from a fee-for-service system to one that sets a budget for keeping a certain number of people healthy.
The administration decided to start with the exchange and the board as the two big pieces of this year's legislation because the federal law requires the states to set up exchanges this year and because the board is to play the lead role in designing the nuts and bolts of the state's system, notes NECN.
However, Shumlin's strategy leaves a number of key details, including how to pay for the system, open for debate. The governor's team plans to return to the legislature in 2013 with funding proposals, Kaiser Health News reports.
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