[F]ormer Gov. Peter Shumlin said Tuesday that Congress should move forward with a Medicare-for-all health care plan at the national level but that states should not try to implement a similar plan on their own.
Shumlin, who served from 2011 to 2017, made the comments at a special event with Harvard’s School of Public Health. Shumlin ran for governor in 2010 promising single-payer health care and abandoned the plan in December 2014, after nearly losing his bid for a third term.
Shumlin, a Democrat, said he still believes in single-payer health care — a system in which the government pays for health care bills instead of private insurance companies — and that Vermont’s experience should be viewed as a lesson instead of a failure.
He said the federal government should gradually increase eligibility for the federal Medicare program, which covers seniors over age 65 and people with disabilities, until everyone in the United States has Medicare coverage. He supports the recent “Medicare-for-all” plan put forth by Sen. Bernie Sanders, I-Vt.
Shumlin said small states like Vermont cannot implement single-payer health care on their own, that Colorado likely won’t be the first state to implement it, but that California may be able to implement it because the state is so big.
In Vermont, Shumlin said he could not implement single-payer health care in large part because of rising health care costs and in large part because he lost so much credibility with the public from the dysfunctional rollout of Vermont Health Connect.
The funding plan Shumlin’s team came up with would have required an 11.5 percent payroll tax plus a 9.5 percent income tax. While those taxes would replace premiums, he said there would be “winners and losers,” and he could not guarantee the state wouldn’t need to raise those taxes even higher if health care costs continued to rise by up to 7 percent per year.
Because the state would be acting like an insurance company, it would have also needed to build up reserves to fund unexpected expenses, Shumlin said. That meant the state would have needed to use all of its bonding capacity for 10 years to build up the reserves, Shumlin said, and not make any improvements to other infrastructure.
Shumlin said the Legislature never would have approved the plan, but said he decided to take the fall and abandon single-payer because it was his idea. Additionally, he said he had a deal with his current wife to end his political career after three terms, so he had the least to lose.
“I couldn’t get the votes,” Shumlin told the interviewer. “There was no way I was going to get the votes in either the House or the Senate to pass the single-payer plan that I wanted. No way.”
“I had Progressive senators coming to me… saying, ‘What if we just slowed down? What if we just invited people into the state employee pool as a first step?’ I was like, ‘Are you kidding me? We buy that from an insurance company.’”
“Most politicians who had a political career would have gone out and said, ‘We’ve done the research, here it is. We’ve done it. We believe in single payer. Legislature, go pass it,’” Shumlin said.
“And it would’ve died in the Legislature quickly, and the governor would’ve said, ‘Those legislators are so incompetent. They’ve got no guts. Why can’t they pass single-payer? It’s the right thing to do. This is Bernie Sanders’ state. Why aren’t we doing this?’”
He said: “I chose not to do that. This was my idea. I owned it, and I needed to own its failure.”
Shumlin also blamed “timing,” because his administration was trying to figure out the funding plan for single-payer at the same time it was managing the dysfunction of Vermont Health Connect, which insures the people who received both commercial health insurance and Medicaid through the Affordable Care Act.
“I lost tremendous credibility as a leader on health care when I couldn’t deliver something as simple, theoretically, as expanding uninsured on Medicaid,” he said.
That was coupled with the Democratic Party losing its control of Congress, which voted dozens of time while Barack Obama was president to repeal the Affordable Care Act, also known as Obamacare, Shumlin said.
Shumlin said he met regularly with the U.S. Department of Health and Human Services seeking waivers to set up single-payer, but Barack Obama’s administration was focused on keeping Obamacare and was not going to be able to make special deals for Vermont to move forward on single-payer.
“The lesson is: I was wrong,” Shumlin said. “I don’t think little states can go it alone, at least little states like Vermont, with an unstable federal partnership.” He pointed to the transition from Obama to President Donald Trump as proof of instability in the federal government.
He endorsed the Medicare for All bill that Sanders introduced Sept. 13. The financing plan for that bill, too, has not been ironed out, but Sanders has endorsed various taxes targeting the wealthiest Americans.
Shumlin said the plan still has promise if the bill means the federal government would allow the Medicare program to negotiate down pharmaceutical costs —- which federal law currently bars Medicare from doing—and bring down the prices of medical devices.
“The Bernie Sanders, Elizabeth Warren plan is the smartest way to go because you can negotiate pharmaceutical costs, if they’ll finally take on the industry, where there can be huge savings,” Shumlin said.“But I think we’ve got to break this system of the money greed or we won’t get there.”
He framed Vermont’s story as, “How a little state tried, learned.” He added: “The lesson should not be, ‘No.’ The lesson should be, ‘Hell yes, let’s get it done. Let’s do it right. And let’s give this benefit to all Americans who get to get it when they’re 65 years old anyway.”
