Governor Peter Shumlin signed legislation (H. 202) on May 26 that creates a health insurance exchange under requirements of the Affordable Care Act (ACA) as well as a five-member board which is to design options and recommendations for the development of a universal state-sponsored program that would offer health insurance benefits to all Vermont residents through a single payment system with uniform payment methods creating incentives for integrated, cost-effective care. The board is to be appointed by October. The board’s initial recommendations concerning the financing and operations of the single payment system are to be presented to the Vermont legislature by January 15, 2013.  The single payment system could be implemented by 2017 if additional state legislation is enacted in 2013 and Vermont obtains multiple federal waivers under the ACA, Medicare, and Medicaid.