In recent years, healthcare reform has been at the forefront of political discussions and policy initiatives across the United States. While the federal government has made efforts to address the challenges within the healthcare system, individual states have also taken steps to enact their own health policy reforms. One such innovative approach to healthcare reform can be seen in Vermont, where the state has implemented a single-payer system. This essay aims to provide an analysis of Vermont’s single-payer system as a state health policy reform innovation, including the rationale for the policy, how it was adopted, the funding structure, and its impact on healthcare access, costs, and ethical outcomes.