With a few strokes of the pen Thursday morning, Gov. Peter Shumlin signed into law a bill that could help Vermont become the first U.S. state to offer a state-run, single-payer health system.

Previously, Shumlin, a Democrat, said the bill would make health care "a right and not a privilege."

Once set up, all Vermont's 625,000 residents could enroll in the state's plan, dubbed Green Mountain Care. However, private insurers could still operate in the state, and the Green Mountain Care plan would ultimately be one of my many plans residents could join once the state sets up an insurance exchange in 2014, as mandated by the Affordable Care Act.

But there are still plenty of hurdles. For one, the law doesn't specify how the plan will be paid for. Rather, it sets up a five-member board that will meet in October to figure out a way to finance it. An outline for the financing plan is due to come before the state's lawmakers Jan. 15, 2013.

"I realize that people have legitimate questions about how a single payer will be financed and operated, and we will answer those questions before the legislature takes the next step," Shumlin said in a statement.

Also, the plan requires a federal waiver, which under current law isn't possible until 2017. However, President Obama has indicated a willingness to let states get waivers as early as 2014.

"The legislation is really more an announcement of intention rather than an accomplishment," David Himmelstein, a professor of public health with City University of New York, told Bloomberg.

According to CBS News, about 50,000 Vermont residents are uninsured, and another 150,000 are underinsured.

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