[JURIST] Vermont Governor Peter Shumlin [official website] signed a health care reform law [H 202 text, PDF] on Friday that promises [press release] to make a state single-payer system. The law, designed to reform Vermont’s entire health care system, will regulate health insurance premiums and health care provider payments, putting providers on a budget and rewarding them for efficiency, rather than a “fee-for-service” structure.

As provided in Sec. 4 of this act, upon receipt by the state of necessary waivers from federal law, all Vermont residents shall be eligible for Green Mountain Care, a universal health care program that will provide health benefits through a single payment system. To the maximum extent allowable under federal law and waivers from federal law, Green Mountain Care shall include health coverage provided under the health benefit exchange established under chapter 18, subchapter 1 of Title 33; under Medicaid; under Medicare; by employers that choose to participate; and to state employees and municipal employees.

Although the law is signed, the plan to fully implement and finance single-payer health care will not be completed until 2014 at the earliest. Shumlin acknowledged that people have questions, and stated the next steps to universal health care will not be taken without the approval of Vermonters.

The law also creates a state health insurance exchange. Some have criticized the law [Burlington Press report] for eventually destroying private health insurance and being impossible to fund. Others suggest it will save [Reuters] $580 million annually, and $1.9 billion by 2019.

Unlike the national Patient Protection and Affordable Care Act (PPACA) [HR 3590; JURIST news archive], the Vermont law guarantees state health insurance to every citizen, whereas the PPACA has a mandate for every citizen to purchase health insurance of some form, likely private unless they are eligible for Medicare. Court challenges to the PPACA continue across the nation. Last week, the American Center for Law and Justice (ACLJ) sought reinstatement [JURIST report] of its dismissed lawsuit challenging the constitutionality of the health care reform law. In April, the US Supreme Court denied [JURIST report] Virginia’s request for the court to rule on the constitutionality of the health care reform law on an expedited basis. A judge for the US District Court for the District of New Jersey rejected [JURIST report] a lawsuit challenging its constitutionality, on jurisdictional grounds of standing [Cornell LII backgrounder], similar to a dismissal [JURIST report] in the US District Court for the District of New Hampshire. A judge for the US District Court for the Northern District of Florida struck down the law in January, while in October, a judge in Michigan upheld the law [JURIST report]. US Courts of Appeal for the Third, Sixth and Fourth circuits are all hearing oral arguments in appeals of lower court rulings, while appeals are pending in the DC circuit as well as the Eighth and Ninth circuits.