Barack Obama wanted to introduce true, single-payer health care similar to what you find in Canada or much of Europe. He didn't get his way due to pushback by Congressional Republicans and a good smattering of Democrats along with the lobbies that buy their votes. So, Americans would up with a "better than nothing" compromise they all seem to call "Obamacare."
We've had plenty of time to observe how issues like gay marriage and legalizing marijuana have progressed through the United States. It usually begins with one or two States implementing change while other States look on and wait to see what happens. It can be an effective means to debunk groundless fears and propaganda. Why, that State got gay marriage and you mean to tell me the entire society didn't collapse? People didn't start sleeping with their dogs? Hmm. Maybe it's not so bad after all.
Something along those lines may be happening on the health care front. Vermont is going "single payer."
Vermont is using authority granted under the Affordable Care Act to start a single-payer system. Most Americans still don't know what the phrase "single-payer" even means. It had little support in Congress in 2009 and Senate "Democrats" like Nelson and Lieberman even killed the public option. But, ACA had this sweet little provision that allowed states to set up a single-payer system and now people will see it in action. You know what that means.
As Senator Bernie Sanders (I-Vt.) opines, "The quickest route toward a national health care program will be when individual states go forward and demonstrate that universal and non-profit health care works, and that it is the cost-effective and moral thing to do.”