Flanking Gov. Peter Shumlin at a Statehouse press conference, the Vermont congressional delegation today announced federal legislation to let states in 2014 provide better health care at less cost.

A provision by U.S. Sen. Bernie Sanders (I-Vt.) in the new federal health care law allows states to propose pilot programs in 2017. Now Vermont's congressional delegates – Sen. Patrick Leahy (D-Vt.), Sanders, and Rep. Peter Welch (D-Vt.) – have drafted a bill to authorize federal waivers three years sooner. Sanders will introduce the bill in the Senate for himself and Leahy, and Welch will introduce the bill in the House.

Sanders said, "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. This is essential not only for the wellbeing 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. I look forward to working with Sen. Leahy and Rep. Welch to get the appropriate waivers and flexibility for us to go forward toward a single-payer system."

Welch said, "When Vermont innovates, the nation often follows our lead. 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. Allowing us to become a laboratory for innovation and excellence will help Vermonters, while once again allowing us to lead the way."

Leahy said, "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. Vermont has always been a leader in health care quality and access, and this bill will give our state the flexibility we want to offer Vermonters the best care and coverage while controlling costs."

Shumlin said The Affordable Care Act "will bring Vermont critical money to make our health care system work better and to cover some of the uninsured. We want to do it better and faster than the federal law contemplates. We want to control costs and cover everyone. I am so pleased that our congressional delegation supports us in this effort, and I thank them for introducing this important legislation. 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."

This press conference came one day before a report is to be delivered to the state Legislature by William Hsiao, the Harvard University economist, outlining health care options for Vermont that could require a federal waiver to be implemented.

The new national health law will provide insurance for 32 million more Americans and make other significant strides, but Leahy, Sanders and Welch said Congress and the Obama administration should let states make additional improvements.

Under their bill, states would be able to seek U.S. Health and Human Services Department approval to implement pilot health care systems beginning in 2014. To qualify, state plans would have to be at least as comprehensive and affordable as the federal model and cover at least as many people. States could not offer lower quality or less affordable coverage. A single-payer system like Vermont is considering or any other state initiative could not cause the federal government to incur more costs.

The waiver provision also requires HHS to create a coordinated process so states in a single application also could seek waivers already available under Medicare, Medicaid, and the children's health insurance program.

A fact sheet on the new "State Leadership in Healthcare Act" is available here.