Advocates of a “Medicare for all” approach were largely sidelined during the national Obamacare debate. The health law left a private insurance system in place and didn’t even include a weaker “public option” government plan to run alongside more traditional commercial ones.
So single-payer advocates looked instead to make a breakthrough in the states. Bills have been introduced from Hawaii to New York; former Medicare chief Don Berwick made it a key plank of his unsuccessful primary race for Massachusetts governor.
Vermont under Shumlin became the most visible trailblazer. Until Wednesday, when the governor admitted what critics had said all along: He couldn’t pay for it.