AHC: Earliest State Level Health Care Reform

What is the earliest a US state could take up the mantle of healthcare reform? It could be anything from a single payer system, to a simply earlier Romneycare. Where might the US healthcare debate go from there?

EDIT CLARIFICATION: I should also clarify -- said statewide HRC has to come before any national level UHC.
 
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Maybe. There have also been Single Payer initiatives at the state level in recent history -- California had it on the ballot in 1994, then passed a bill providing it in 2006 (it was vetoed by Schwarzenegger). Oregon had such a ballot initiative in 2002, and Massachusetts had such a debate in 2000.
 

Delta Force

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Louisiana in the 1930s? From Wikipedia:

"Long founded the LSU School of Medicine in New Orleans. He also doubled funding for the public Charity Hospital System, built a new Charity Hospital building for New Orleans, and reformed and increased funding for the state's mental institutions. Long's statewide public health programs dramatically reduced the death rate in Louisiana and provided free immunizations to nearly 70 percent of the population."
 
Louisiana in the 1930s? From Wikipedia:

"Long founded the LSU School of Medicine in New Orleans. He also doubled funding for the public Charity Hospital System, built a new Charity Hospital building for New Orleans, and reformed and increased funding for the state's mental institutions. Long's statewide public health programs dramatically reduced the death rate in Louisiana and provided free immunizations to nearly 70 percent of the population."

Very possible.

Another option from the same era: Upton Sinclair wins the California governor's race in 1934.

Going back a bit further into the Progressive Era, perhaps a movement for state healthcare takes off among Scandinavian and/or German immigrants somewhere in the Midwest? Bismarck started state-subsidized care in Germany sometime in the late 1800s as did Sweden, as I recall.
 
Found the perfect PoD area -- in 1915, the American Association of Labor Legislation drafted a sample bill, which effectively provided the same kind of health, sickness, and death insurance found in Germany, and submitted it to various state legislatures. (Interesting note: the AMA initially supported these measures.) Though there were efforts in something like eight states (including the four largest of the time: NY, PA, IL, and OH), California probably came closest; however, they ended having their referendum on the question of establishing UHC at just about the worst possible time for any piece of progressive legislation, in November of 1918. If any of the major forces working against the law were removed -- say, the anti-German scare that OTL accompanied US entry into WWI -- I can easily see at least one of these measures getting passed by 1920, with Cali as the leading candidate.

Also something that might have potential -- maybe if Washington state's Initiative 172 -- which, FWIG, provided healthcare for those on government aid -- hadn't gotten derailed by Red Scare politics, budget gridlock, and the 1950 counter-referendum.

Bismarck started state-subsidized care in Germany sometime in the late 1800s as did Sweden, as I recall.

You're right about Bismarck -- his government passed three laws in the 1880's that pretty much established the German healthcare system. Sweden however, FWIG, didn't really have anything like UHC until after WWII (which is when a lot of other countries we're starting to adopt and experiment with their UHC systems)...
 
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