After Obamacare was signed into law, some states built health insurance exchanges. Others opted for something different, such as in Arkansas, where state leaders built a private option.

But in Vermont, the idea was to one-up the president by building a single-payer system like ones in Canada and Europe. Green Mountain Care, as it's become known, was a top priority for Gov. Peter Shumlin during his campaign for the governor's office and during his tenure.

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But over the past few years, reality set in. And Shumlin in December announced plans to table the effort to build Green Mountain Care, citing issues with the system's effect on small business, working families and the state's budget.

"I have always made clear that I would ask the state to move forward with public financing only when we are ready and when we can be sure that it will promote prosperity for hard-working Vermonters and businesses, and create job growth," Shumlin said in a statement.

"Pushing for single payer health care when the time isn't right would not be good for Vermont and it would not be good for true health care reform. It could set back for years all of our hard work toward the important goal of universal, publicly-financed health care for all. I am not going to undermine the hope of achieving critically important health care reforms for this state by pushing prematurely for single payer when it is not the right time for Vermont. In my judgment, now is not the right time to ask our legislature to take the step of passing a financing plan for Green Mountain Care."

Vermont's single-payer experiment had been a closely watched process by many across the nation — health insurers, hospitals, media outlets and political operatives. And while polls in Verment showed general support for single-payer, it did face opposition from local constituents.

"We were thrilled, and cautiously optimistic," says Darcie Johnson, founder and president of Vermonters for Health Care Freedom, a leading opponent of single payer. "We knew that, yes he's tabled the direct single-payer finance plan because the numbers they came out with were indeed the very same numbers that we projected three years ago. This was not a hard thing to figure out that it was going to be a huge economic burden."

There are several reasons single-payer in Vermont wasn't going to work. The biggest was finances.

For starters, Shumlin and his allies insisted on an actuarial value of 94 percent. Even the plan's outside architects — economists William Hsiao of Harvard and MIT's Jonathan Gruber (yes that Jonathan Gruber) called for a lower actuarial value. By keeping the actuarial value at 94 percent, the costs for the program ballooned. 

Gruber's outspoken, some say arrogant, comments concerning his work on PPACA, which came to light in December of 2014, also could have played a role in Shumlin's decision.

"I think between the Jonathan Gruber backlash and the 94 percent actuarial value, they used it to change course," Johnson says. "I think the left is upset about it. It could have been 83 and 85 percent actuarial value and it would have made the taxes affordable. I know from other conversations that the governor wanted the Vermont state employees' endorsement, and to get that endorsement, they had to agree to 94 percent because that's what they have now."

With cost projections rising for Green Mountain Care, there was going to have to be tax increase — not just one on businesses large and small, but on individuals, as well.

Green Mountain Care would have levied an 11.5 percent payroll tax on all Vermont businesses and instituted an income-based premium structure ranging from 0 percent to 9.5 percent. For small business Green Mountain Care's costs would have added additional four points on the payroll tax or a 50 percent increase in the income tax.

"They were going to put a tax on people who never paid for health care and it was going to be huge," Johnston says. "They were really caught between a rock and a hard place, because they couldn't figure out a way to scale this tax up on people who weren't used to paying for health care."

Several other economic factors came into play as well.

Vermont over-anticipated the amount of federal funds they would receive for its transition by $150 million and sluggish economic growth which contributed to $75 million shortfall in general fund revenue. Johnson also added that state income tax coffers are feeling a pinch — coming in at $18 million under projections.

"Change is difficult to achieve," Shumlin said in announcing the stoppage. "And worthy causes take time to take root.  A better, fairer, more rational, and more sustainable way to pay for health care is worth fighting for. We must continue our hard work and our successes. Our time will come."

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