Sanders puts brave face on single-payer troubles

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Sen. Bernie SandersBernie SandersWebb: The race to 270 Arizona and Georgia: Not swing states — yet The American electorate is pulling apart MORE (I-Vt.) says that single-payer healthcare did not fail in Vermont and could be revived, amid speculation that flailing efforts in that regard could hurt his 2016 presidential hopes.

Sanders, a self-described socialist, has been a champion of nationwide government-provided health insurance for everyone, known as single-payer healthcare. 

But a plan to enact just such a system in Sanders’s home state of Vermont suffered a major setback in December when Gov. Peter Shumlin (D), who had been a champion of the effort, dropped the proposal, concluding it was not financially feasible. 

Sanders told The Hill in a brief interview that the plan did not fail. 

“It's not that it hasn't worked out, it hasn't been implemented,” he said. “So I think that in Vermont, many of us, including the governor, are planning about how we go forward.”

Sanders added that the debate is “certainly not finished,” but declined to elaborate further. His office did not respond to a request to expand on his comments. 

Sanders is considering a run for president, challenging Hillary Clinton from the left in a longshot bid for the Democratic nomination. 

If he runs, the single-payer experience in his home state will be subject to scrutiny.

When Shumlin signed a bill to set the single-payer process in motion in 2011, it was seen as a nascent success story for advocates of the system. Sanders had once argued that Vermont could be a prototype that would demonstrate how a nationwide system could work. 

“If Vermont can pass a strong single-payer system and show it works well, it will not only be enormously important to this state, it will be a model,” Sanders said in 2013. 

Instead, the plan has fizzled. The 2011 bill did not set out the details of how to pay for the plan. In December of last year, facing the need for an 11.5 percent tax on all Vermont businesses, and personal income tax hikes of up to 9.5 percent in order to pay for the plan, Shumlin called it off. 

“The risk of economic shock is too high at this time to offer a plan I can responsibly support for passage in the legislature,” Shumlin said in announcing his decision. 

The $4.3 billion per year cost of the plan would have been almost as much as Vermont’s total state budget, around $5 billion.

“This is a big pot of money in a small state,” said Art Woolf, an economist at the University of Vermont. “[Shumlin] just thought that we couldn't afford it and made the pretty rapid decision to drop his support.”

Sanders is still pressing ahead with his push for a nationwide system.

“Despite the fact that more than 40 million Americans have no health insurance, we spend almost twice as much per capita on healthcare as any other nation,” he said in a speech last week at the Brookings Institution. “We need to establish a Medicare-for-all, single-payer system.”

Opponents of single-payer have pounced on Vermont’s experience.

The National Federation of Independent Businesses has called for the repeal of the original 2011 bill in order to end the plan completely. Shumlin has left the door open for it to return in the future.

“Now that we have heard definitively that single-payer implementation is fiscally unsustainable, we must go back to the drawing board,” Shawn Souldice, NFIB’s Vermont director, said in a statement.

Bertram Johnson, a professor of political science at Middlebury College in Vermont, said that while the state’s experience is at least somewhat different because of its small size, “I don't think that will stop this from being a potent example for anti-single payer forces.

“With Democratic supermajorities in both the House and Senate and a Democratic governor [who was supportive], it's a disappointment for single-payer advocates,” he added.

The experience in Vermont could play into a Sanders presidential campaign, with the intensity of the attacks on him increasing if he gains more viability.

“If Sanders became anything more than a sparring partner for Hillary Clinton, that could be an issue that could be brought up in a debate,” said Dante Scala, a political scientist at the University of New Hampshire, next door to Vermont and the state with the first presidential primary.

Henry Aaron, a healthcare expert at the Brookings Institution in Washington, said that if the plan did not work in liberal Vermont, it is unlikely to pass muster in other states. 

"If you wanted to pick a state where the politics were more favorable, you would be hard pressed to find a better one," he said.