How Math, Lawsuits, and Jonathan Gruber Killed Vermont's Single-Payer Health Care Dream

A progressive state gives up on a cherished health care dream.

Massachusetts Institute of Technology Economics professor Jonathan Gruber testifies before the House Oversight and Government Reform Committee about his work on the Affordable Care Act in the Rayburn House Office building on Capitol Hill December 9, 2014 in Washington, DC

Photographer: Chip Somodevilla/Getty Images

"I think we have the chance to make history here," wrote Jonathan Gruber.

It was the summer of 2014, and Gruber, who had yet to become the infamous goat of the Affordable Care Act debate, was consulting with the state of Vermont on its health-care reforms. He was not wrong: Vermont, run stem-to-stern by Democrats since the 2010 election, was attempting to use the benefits of the ACA to enact single-payer, universal health care coverage. If successful, it would bring about the dream of Canadian-style care to one state. Who could say which states would follow suit? Maybe all of New England? Maybe all 50?

Months later, Gruber's contract with the state was quietly wrapped up. And yesterday, Governor Peter Shumlin pre-empted an end of year report on the single-payer effort by announcing that the reform plan would be set aside. "The bottom line," he said, "is as we completed the financing modeling in the last several days, it became clear that risk of economic shock is too high at this time to offer a plan that I can responsibly support for passage in the Legislature."

It was a resounding defeat for progressive governance, and conservatives are giving a little backhanded credit to Gruber. Tea Party activist and contributor Michael Patrick Leahy calls the single-payer plan the "first casualty" of Gruber's gaffes. Ever since conservative watchdogs dug up a video of Gruber mocking a constituent complaint about single-payer, Gruber had been sidelined as an effective, trustworthy advocate for the plan. That was especially problematic as a state representative from Shumlin's own party, Cynthia Browning, was suing the state for more records about the cost estimates.

"If I’d have gotten the documents I asked for in March, Vermonters would have known more about this plan and would have had a chance to make suggestions and criticisms," Browning said this week in an interview with Vermont Watchdog's Bruce Parker. "At this point it’s very hard for me to trust anything this administration says. Even if the reports they put out have valid data, they don’t tell the rest of the truth."

Browning probably deserves more credit for the public skepticism than Gruber; mathematics deserves the credit for Shumlin's decision. As Vox's Sarah Kliff explained, Shumlin only caved on single-payer after the Green Mountain Care Board issued a report that reduced expectations for how the program could be funded. The monies from ACA waivers and Medicaid were falling short, which meant that single-payer could only be implemented, by 2017, with a new 11.5 percent income tax.

That could not happen given Shumlin's current political capital. Leave aside the legal volleying from his own party. Shumlin, the 2014 chairman of the Democratic Governors Association, had a disastrous year. Not only did his party lose winnable races in Maine, Massachusetts, and Maryland; Shumlin himself has not yet been re-elected. He stumbled against an underfunded Republican opponent, edging him by 1 percent of the vote, and falling short of the 50 percent needed for outright victory. The governor's opponent had promised to "end the failed health care experiment,"and nearly done so. To return to power, Shumlin needed the legislature to re-elect him, a few weeks after the Green Mountain Care Board's report.

He had no political capital, so he didn't spend it. That came as a shock to plenty of people expecting Vermont to "make history." On Monday, I interviewed Vermont Senator Bernie Sanders, and asked why he thought Shumlin had nearly lost. Did it have anything to do with a single payer/tax backlash?

"No, I think we had the lowest turnout in history," said Sanders. "We should learn from what happened last month. The American people are very demoralized right now."

Sanders, the only self-declared socialist in the Congress, has not commented or responded to a request for comment about Shumlin's single-payer decision.

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