ABSTRACT
The antecedents of the Vermont Health Reform Act can be traced at least as far back as 1979, when the state enacted a certificate-of-need law requiring hospitals and other health care institutions to apply to the Health Department for review and approval of new capital expenditures and the introduction of new health services. Vermont's first foray into dealing with its uninsured population came in 1987 when the legislature created the Vermont Health Insurance Plan (VHIP), The legislation set up a VHIP board comprising of representatives of low income people, business groups, and the provider industry. Rivers and Conrad were joined by two liberal Vermont political heavyweights. The first was the state branch of the National Educational Association, Vermont-NEA, with nearly eight thousand members and one of the best lobbying organizations in the state. The second force behind the single-payer campaign was Vermont's maverick, and politically astute, congressman, Bernie Sanders.
