Vermont is the first state who may actually have single payer health insurance become a reality. The Vermont House has passed a single payer bill which might actually get through the Vermont Senate, too.

Boston.com:

"This bill takes our state one step closer to a system that ensures that all Vermonters have access to the care they deserve and contains costs," House Speaker Shap Smith said shortly after the House passed the bill 92-49.

The measure now goes to the Senate, where it is expected to pass, but with some possible changes.

Gov. Peter Shumlin, who made single-payer health care a centerpiece of his gubernatorial campaign last year, also praised the legislation. He said it would make Vermont "the first state in the country to make the first substantive step to deliver a health care system where health care will be a right and not a privilege, where health care will follow the individual, not be a requirement of the employer, and where we'll have an affordable system that contains costs."

Under the proposed plan, Vermont would create a state-run insurance exchange which would then be converted to the single-payer model in 2013. Despite Republican efforts to exempt some businesses who self-insure their health benefits, the Democrats remained united and passed it without those exemptions.

This is how it will happen. One state at a time. Watch Vermont to see how it's done.