MONTPELIER (AP) -- The health care committee of the Vermont House began Friday lining up some of the "heavy lifting" tasks that will have to be finished before the state can roll out its first-in-the-nation single payer health care system scheduled for 2017.
The House Committee on Health Care heard from legislative staff members and outlined the details that have yet to be worked out -- such as who would be covered and when to seek formal permission from the federal government to run a system that would go beyond the scope of the Affordable Care Act.
Many of the details discussed Friday won't be part of the financing plan Gov. Peter Shumlin is expected to release next year.
"What's envisioned here is a different gatekeeper; the gate-keep to get health care is being a Vermonter. Today the gatekeeper is paying a premium before you show up for emergency surgery," Committee Chairman Michael Fisher, D-Lincoln, said during the hearing.
On Tuesday, Shumlin appeared before a joint meeting of the House and Senate health care committees and recommitted the state to reaching its goal of becoming the first state in the country to create what he called a with "a universal, publicly-financed health care system."
Shumlin made the comments after expressing his frustration with the roll-out of Vermont's version of the federal health overhaul, which has been plagued by problems.
In the same speech, Shumlin urged lawmakers to focus on the details of reaching that goal, "work that will require heavy lifting."
The committee on Friday got a glimpse of some of the weighty issues at play. The staff members suggested creating a timeline of tasks as well as the areas that need to be addressed over the next three years.
Leaving aside the details of how the single-payer system will be financed, there are questions to be answered about when to begin collecting those funds.
"Do you need to start collecting money before the system gets in place in preparation for the transition costs?" asked Catherine Benham, of the Legislature's Joint Fiscal Office. "And then there's the whole issue of how you navigate who's paying what, when," she said.
Fisher acknowledged there is a lot of work to do, including reconciling the different ideas being considered by different legislative committees.
"Next year when there's discussion about really passing this stuff we'll need to chart out the process," Fisher said.