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Thursday, October 01, 2009

Validation: a public option George Wallace in his heyday could love

Via Washington Post healthcare guru-pundit Ezra Klein, as reported in the Washington insider blog Politico, we see the possible compromise being bandied about in Congress of a “state's right” to opt out of the public option. This is a trial balloon being floated by Delaware Senator Tom Carper as an end run to break the public option blockage and give the Blue Dogs and the two sane Republicans the fig-leaf they need, while making the public option available to almost everyone -- indeed, probably in the end, to everyone.

Not to brag too much, and I neglected to enter it as a post on Scatablog, but I suggested the same thing a couple of weeks ago in a comment on another website. Nice to see my ideas reach into the U.S. Senate. It seems like a pretty good idea – allow opt-out by a referendum under state law -- and the reality is that no state in the end will opt out of simply having the option available. The voters will not give up that option. Meanwhile, I just think the politics of it -- hoisting them by their own petard -- is simply perfecto!

You want compromise?

OK, here's a compromise: let states opt out of letting the public option be made available to their residents. Disperse the battles. Limbaugh and Hannity can expend their energy trying to start and fan fires in Little Rock, Austin, Oklahoma City, Montgomery, Jackson, Atlanta, Columbia, Jackson, Baton Rouge, Lincoln and Salt Lake City.

Meanwhile, we in New York, Massachusetts, Connecticut, Vermont, New Hampshire, Maine, Rhode Island, New Jersey, Pennsylvania, Maryland, D.C., Virginia, Delaware, Ohio, Michigan, Wisconsin, Illinois, Iowa, Minnesota, Colorado, New Mexico, Nevada, California, Oregon, Washington and Hawaii will have the public option available to us. That's a decent-sized risk pool. Residents of the recalcitrant Red States can see the pop-up on the Exchange website, "Sorry, the Public Option is not available to residents of Mississippi, etc."

Of course, when the focus is on exactly what the public option is, the residents of the Red States are not going to support not even having the choice. The opposition will fizzle."

I suspect the present concept that the public option will really be available to only those who do not have coverage through an employer will remain in play. However, this does not seem objectionable in the real world (and may be necessary to close the deal) becausee employers will usually subsidize the premiums for plans they offer. It seems unlikely that the public option could be cheaper than subsidized workplace plans, so I doubt anyone covered through the workplace would prefer the public option anyway. Remember that all the bills establish minimum standards for all health insurance.


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