1. How did we get here? What does it do? What needs to happen next? Ellen Oxfeld PNHP Annual Meeting October 29, 2011

2. Two decades of activism – just a few highlights! Rallies for over ten years Meetings, forums (in the hundreds) Town Meeting Day resolutions passed in many towns in 2005 Huge effort by single payer supporters during Democratic primary in 2010 (Peter Shumlin won by only 200 votes)! Work to get business groups, public citizen groups, unions, and health professional groups to coalesce around the concept. This is still ongoing! “Inside/Outside” strategy

3. A strong statement of intent that includes reference to health care as a public good that should be publicly financed and should cover all Vermonters in a seamless manner. A timetable that requires the state to seek a waiver “as soon as allowed under federal law” to allow the suspension of the health benefit exchange and the transition to Green Mountain Care, utilizing federal monies. A “road map” to universal care that envisions a transition from the federal health benefit exchange to Green Mountain Care, a publicly funded universal system. Cost containment by reducing administrative expense, and by health system planning and budgeting. Ongoing evaluation of “payment reform pilots” to guard against adverse effects on patients.

4. Green Mountain Care will not include ERISA employers Medicare and Medicaid recipients will not be folded into Green Mountain Care The legislation does not include global budgets The package will not be comprehensive

5. Legislature must still approve two additional pieces of legislation: A financing act (tax) Appropriations First precondition to implementation is waiver of ACA. If ACA is overturned by Supreme Court, amendment of Act 48 needed. Legislature still has to establish rules for Exchange (which can ironically impact single payer).

6. There is a large population of involved people in the state, and we need to keep this going. Shumlin administration is genuinely committed to single payer, and some members of the new Board are absolutely true blue single payer The process has been and continues to be open.

7. Exchange has many problems and public could confuse this with “single payer.” Act 48 was the “easy” part. We will have to mobilize people to get behind the financing package (but emphasize that these new taxes will replace premiums). Need to keep our eyes on all things at once – benefit package must stay comprehensive, financing must be progressive – this means keeping the public involved! Governor Shumlin needs to be re-elected, and legislature needs to stay committed (which means public support must continue to be organized).