BRATTLEBORO - Vermont's congressional delegation joined Gov. Peter Shumlin on Tuesday to announce new federal legislation that would allow the state to move forward with its health reform efforts in 2014.

During a Statehouse conference with the governor, U.S. Sens. Patrick Leahy and Bernard Sanders and U.S. Rep. Peter Welch, introduced a new draft to authorize federal waivers for Vermont three years sooner than the current health care law.

Sanders, I-Vt., added a provision in the federal bill allowing states to propose pilot programs in 2017, but this new provision would shorten that wait to 2014.

He will now introduce a new bill for himself and Leahy, D-Vt., in the Senate. Welch, D-Vt., will sponsor the bill in the House.

Under the provisions of the so-called "state innovation waiver" in the Patient Protection and Affordable Care Act authored by Sanders, individual states could solicit the U.S. Health and Human Services Department for approval to implement a pilot health care system by 2014. Plans for each state would have to remain as comprehensive and affordable as the federal model in order to qualify for the waiver.

States interested in seeking a waiver would have to offer the same quality of affordable coverage and ensure it would not cause the federal government to incur more health care costs.

"At a time when 50 million Americans lack health insurance and when the cost of health care continues to soar, it is my strong hope that Vermont will lead the nation in a new direction through a Medicare-for-all single-payer approach. The goal is clear - quality, cost-effective health care for all Vermonters," Sanders said.
"This is essential not only for the well-being of all Vermonters, but for job creation. We must do all we can to lower the crushing costs of health care that are now devastating Vermont businesses and their employees," he added.

The waiver provision will work as follows if accepted: - The state passes a universal access model and sends it to Washington, D.C.

The Health and Human Services and Treasury departments will review it to determine if the plan is as comprehensive as federal standards, is at least as costeffective and covers an equivalent amount of people.

- If the federal government finds the alternative model meets the requirements without certain federal rules, the state may obtain a waiver.

Shumlin, a Democrat sworn into office on Jan. 6, said he is grateful to Vermont's congressional team for its extraordinary support in the effort to implement a single-payer system. This new waiver gives "Vermont flexibility after 2014 to be the incubator for needed reform right here in Vermont," said the governor.

"I know it can work, but it's going to require a partnership between Vermont and Washington to allow us to go our own way," he added. "This is just the beginning of this process, and there are other waivers we will need to get it done. If we work together, I am convinced we can persuade the federal government they should not stand in our way."

For the wavier to gain traction, Vermont lawmakers will need support from the White House.

Shumlin told the Reformer that President Barack Obama is willing to work with the state as long as current federal standards are not reduced.

"I am encouraged by my conversations with the White House," he said.

Moving ahead with the proposal could present a challenge on Capitol Hill as the new Republican majority in the U.S. House has listed repealing portions of the landmark health care legislation as a top priority.

"With the 112th Congress officially under way, the new majority is wasting no time answering the call of the American people to cut spending immediately, repeal 'ObamaCare' and change the way Congress works," said U.S.

House Speaker John Boehner, R-Ohio, earlier this month. "On [Jan. 7], the House voted to move forward with repealing the jobkilling health care law and replacing it with common sense reforms that lower costs and protect jobs. In the days ahead, this simple two-page repeal bill will come before the full House for an up-or-down vote."

The repeal vote will likely take place today.

Welch, Vermont's sole House member, questions why his GOP counterparts would destroy the good provisions in the bill instead of correcting the bad ones. For the newly proposed waiver, the argument is not about a singlepayer system but state flexibility to allow officials to pursue models that make the most sense for each state, he said.

But even with the likely partisan gridlock in 2011, Leahy said Vermont can continue to lead the nation in health care coverage while controlling costs.

"While some in Washington are trying to turn the clock back on health reform, Vermont instead is moving forward. This state waiver bill will give Vermont and other states the choice to go above and beyond what the federal health care law does by devising their own reforms," Leahy said.

Welch agreed, saying the nation follows Vermont's lead when the Green Mountain State innovates.

"Providing Vermont and other states with the flexibility to build upon health care reform will result in better care and greater access at a lower cost," he said. "Allowing us to become a laboratory for innovation and excellence will help Vermonters, while once again allowing us to lead the way."

The governor's press conference in Montpelier came one day before William Hsiao, a Harvard economist, will speak before the

Legislature about health care options in the state.