White River Junction One high-profile website snafu. Some encouraging skirmishes against rising health care costs. And steady work on Vermonts effort to create a single-payer health insurance plan that covers all residents although with only vague answers to the looming, $2 billion question of how to pay for it.

Thats the health care reform resume that Vermont Gov. Peter Shumlin will put before the voters when he seeks re-election Nov. 4.

The election is more than a referendum on health care policy. Candidates have had a lot to say about shrinking school enrollment, painful property tax increases and mixed economic signals.

But health reform remains a key issue facing Shumlin, the Democrat who currently occupies the corner office in the Statehouse, and his leading challengers: Republican Scott Milne, a travel agency owner from Pomfret, and Libertarian Dan Feliciano, an Essex management consultant.

Three polls since late August showed Shumlin with a double-digit lead, making him one of four Democrats rated a likely winner in a fall governors race by the RealClearPolitics.com website.

State Sen. Anthony Pollina, a Progressive who has long called for a single-payer health care system in Vermont, said that he expected Shumlin to win re-election, but expressed concern that winning by a narrow margin or with only a plurality would leave him with his mandate to move ahead with single-payer greatly dampened.

In 2011, Act 48 wrote into law Vermonts commitment to reform health care. It established the Green Mountain Care Board to rein in spending and laid out a framework for establishing a single-payer insurance system by 2017.

Single-payer insurance systems, such as exist in Canada and many other developed countries, include all residents and pay for health care with revenue collected through broad-based taxes. Some critics of the current health care system in the United States have advocated for single-payer insurance to replace the current system, in which most commercial insurance is tied to employment and premiums are paid by employers and employees. Although millions of American service members, veterans, seniors and low-income families get coverage through government programs, an estimated 42 million people lacked health insurance in 2012, according to the Kaiser Family Foundation.

Single payer was a plank in the platform of Shumlins successful run for governor in 2010. He said his signature on Act 48 would launch the first single-payer system in America, to do in Vermont what has taken too long for the country.

But even as the Shumlin administration embarked for the distant shore of single payer, it had to navigate the shoals of the 2010 Affordable Care Act. Along with a requirement that everyone have health insurance, that federal law made each state responsible for giving its residents a way to shop for commercial insurance on a website built and operated by the state, the federal government, or the two together.

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Health Care Reform at Center of Vt. Gov. Race