Question: Who became the first state to hvae universal health insurance?
About the article "United States", section "Health".

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The United States does not have a universal health care system, however the Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care and Education Reconciliation Act of 2010, seeks to have expanded insurance coverage to legal residents by 2014.
It provides for federally mandated health insurance to be implemented in the United States during the 2010–2019 decade with the Federal government subsidizing legal resident households with income up to 400% of the Federal poverty level.
This threshold varies according to State and household size, but for an average family of four, subsidies would be available for families whose income was about $88,000 or lower.
In June 2010 adults with pre-existing conditions became eligible to join a temporary high-risk pool.
In 2014 applicants of the same age began to be able to obtain health insurance at the same published rate regardless of health status — the first time in U.S. history that insurers no longer had the right to load the premium or deny coverage prior to contract, or cancel a policy after contract due to an adverse health condition, or test result indicating that one may be imminent.
The law prohibits insurers from capping their liability for a person's health care needs, a move which is expected to rectify medically induced bankruptcy.
The Congressional Budget Office and related government agencies scored the cost of a universal health care system several times since 1991, and have uniformly predicted cost savings, partly from the elimination of insurance company overhead costs.
In 2009, a universal health care proposal was pending in Congress, the United States National Health Care Act (H.R.
676, formerly the "Medicare for All Act").
The Congressional Budget Office (CBO) estimated that the bill would reduce the number of nonelderly people who are uninsured by about 32 million, leaving about 23 million nonelderly residents uninsured (about one-third of whom would be illegal immigrants).
Under the legislation, the share of legal nonelderly residents with insurance coverage would rise from about 83 percent in 2010 to about 94 percent by 2019.
In May 2011, the state of Vermont became the first state to pass legislation establishing a Single-Payer health care system.
The legislation, known as Act 48, establishes health care in the state as a "human right" and lays the responsibility on the state to provide a health care system which best meets the needs of the citizens of Vermont.
The state is currently in the studying phase of how best to implement this system.
A revised estimate in July 2012 by the CBO stated 30 million people would gain access to health insurance under the law.
Discussion in the United States commonly uses the term Socialized medicine to impart a pejorative meaning to the idea of universal health care. 
The Australian Government provides a basic universal health insurance, Medicare.
Private health insurance in Australia is limited to those services not covered by Medicare or to services provided in private hospitals.
The Australian Taxation system encourages middle to high income earners to take out Private Health Insurance.
While most taxpayers pay a 1.5% Medicare levy, an additional 1% Medicare Levy Surcharge is payable by those taxpayers who earn more than $88,000 and do not have Private Health Insurance. 
In September 2007, Vitter opposed an increase of $35 billion for the State Children's Health Insurance Program (SCHIP), the national program to provide health care for children from families who earn too much to qualify for Medicaid but cannot afford private health insurance.
He said he preferred that private health insurance provide the needed care and deemed the bill as "Hillarycare", a reference to the 1993 Clinton health care plan created by Hillary Clinton which proposed universal health care. 
Romney was at the forefront of a movement to bring near-universal health insurance coverage to the state, after a business executive told him at the start of his term that doing so would be the best way he could help people and after the federal government, due to the rules of Medicaid funding, threatened to cut $385 million in those payments to Massachusetts if the state did not reduce the number of uninsured recipients of health care services.
Despite not having campaigned on the idea of universal health insurance, Romney decided that because people without insurance still received expensive health care, the money spent by the state for such care could be better used to subsidize insurance for the poor.
After positing that any measure adopted not raise taxes and not resemble the previous decade's failed "Hillarycare" proposal, Romney formed a team that beginning in late 2004 came up with a set of proposals more innovative than an incremental one from the Massachusetts Senate and more acceptable to him than one from the Massachusetts House of Representatives that incorporated a new payroll tax.
In particular, Romney successfully pushed for incorporating an individual mandate at the state level.
U.S.
Senator from Massachusetts Edward M. Kennedy, who had made universal heath coverage his life's work, gave Romney's plan a positive reception, which encouraged Democratic legislators to work with it.
The effort eventually gained the support of all major stakeholders within the state, and Romney helped break a logjam between rival Democratic leaders in the legislature.
On April 12, 2006, Romney signed legislation that mandates that nearly all Massachusetts residents buy or obtain health insurance coverage or face a penalty (up to approximately $2000 for 2008 or equal to half of the lowest cost premium offered) in the form of an additional income tax assessment.
The bill established a regulatory authority called the Commonwealth Health Insurance Connector Authority to implement the law and establish insurance standards.
For residents below certain income thresholds and without adequate employer insurance, state subsidies were established, by using funds previously designated to compensate for the health costs of the uninsured.
Legislation, effective on July 1, 2007, requires health insurance for all state residents, provided a plan is available to the individual that is deemed affordable according to Commonwealth Health Insurance Connector Authority.
In Massachusetts, a roughly $800 million fund known as the "uncompensated care pool" was used to partially reimburse hospitals for expenses related to treating uninsured patients.
The fund's revenue comes from an annual assessment on employers, insurance providers and hospitals, plus contributions of state and federal tax dollars.
Governor Romney's plan redirects money from this fund to subsidize health insurance costs for low-income residents of Massachusetts.
The Romney Administration consulted with Massachusetts Institute of Technology professor Jonathan Gruber to study the state's population and health care needs.
They determined that there was enough money in the "free care pool" to implement the Governor's plans, but that it would require more people to buy health insurance at full price in order to pay into the subsidized fund.
The legislature amended Romney's plan, adding a Medicaid expansion for children and imposing an assessment on firms with 11 or more workers who do not offer health coverage.
The assessment is intended to equalize the contributions to the free care pool from employers that offer and do not offer coverage.
The General Court also rejected Romney's provision allowing high-deductible health plans.
Romney vetoed eight sections of the health care legislation, including a $295-per-person fee on businesses with 11 employees or more that do not provide health insurance.
Romney also vetoed provisions providing dental and eyeglass benefits to poor residents on the Medicaid program, and providing health coverage to senior and disabled legal immigrants not eligible for federal Medicaid.
However, the state legislature overrode all of the vetoes.
Romney said of the measure overall, "There really wasn't Republican or Democrat in this.
People ask me if this is conservative or liberal, and my answer is yes.
It's liberal in the sense that we're getting our citizens health insurance.
It's conservative in that we're not getting a government takeover."
The law was the first of its kind in the nation and became the signature achievement of Romney's term in office.
When Romney's official portrait was made for the Massachusetts State House, the composition included a leather binder with a medical seal representing the healthcare legislation. 
Medicare in the United States is a single-payer healthcare system, but is restricted to only senior citizens over the age of 65, people under 65 who have specific disabilities, and anyone with End-Stage Renal Disease.
Government is increasingly involved in U.S. health care spending, paying about 45% of the $2.2 trillion the nation spent on individuals' medical care in 2004.
However, studies have shown that the publicly administered share of health spending in the U.S. may be closer to 60% as of 2002.
According to Princeton University health economist Uwe Reinhardt, U.S. Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) represent "forms of 'social insurance' coupled with a largely private health-care delivery system" rather than forms of "socialized medicine."
In contrast, he describes the Veterans Administration healthcare system as a pure form of socialized medicine because it is "owned, operated and financed by government."
In a peer-reviewed paper published in the "Annals of Internal Medicine", researchers of the RAND Corporation reported that the quality of care received by Veterans Administration patients scored significantly higher overall than did comparable metrics for patients currently using United States Medicare.
The United States National Health Care Act (or the "Expanded and Improved Medicare for All Act," ), is a bill introduced in the United States House of Representatives by Representative John Conyers (D-MI).
The bill had 88 cosponsors in 2009.
The act would establish a universal single-payer health care system in the United States, the rough equivalent of Canada's Medicare, the United Kingdom's National Health Service, and Taiwan's Bureau of National Health Insurance, among other examples.
Under a single payer system, all medical care would be paid for by the Government of the United States, ending the need for private health insurance and premiums, and probably recasting private insurance companies as providing purely supplemental coverage, to be used when non-essential care is sought.
The bill was first introduced in 2003, when it had 25 cosponsors, and has been reintroduced in each Congress since.
During the 2009 health care debates over the bill that became the Patient Protection and Affordable Care Act.
H.R.
676 was expected to be debated and voted upon by the House in September 2009, but was never debated.
The Congressional Budget Office and related government agencies scored the cost of a single payer health care system several times since 1991.
The General Accounting Office published a report in 1991 noting that "the US were to shift to a system of universal coverage and a single payer, as in Canada, the savings in administrative costs [10 percent of health spending would be more than enough to offset the expense of universal coverage.” The CBO scored the cost in 1991, noting that "the population that is currently uninsured could be covered without dramatically increasing national spending on health" and that "all US residents might be covered by health insurance for roughly the current level of spending or even somewhat less, because of savings in administrative costs and lower payment rates for services used by the privately insured.
A CBO report in 1993 stated that "net cost of achieving universal insurance coverage under this single payer system would be negative" in part because "consumer payments for health would fall by $1,118 per capita, but taxes would have to increase by $1,261 per capita" in order to pay for the plan.
A July 1993 scoring also resulted in positive outcomes, with the CBO stating that, "the program was phased in, the administrative savings from switching to a single-payer system would offset much of the increased demand for health care services.
Later, the cap on the growth of the national health budget would hold the rate of growth of spending below the baseline."
The CBO also scored Sen. Paul Wellstone's American Health and Security Act of 1993 in December 1993, finding that "by year five (and in subsequent years) the new system would cost less than baseline.