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The Public Option ‘Opt-Out’



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It looks like the Democratic leadership is coverging around a “public option” government-run insurance plan. Reid et al hope to bring moderates on board by allowing states to opt out:

Mr. Reid spent the weekend shoring up support for the bill from Democrats in the chamber. But some key moderate Democrats signaled Sunday that they remain uneasy about main planks of the legislation. “I certainly am not excited about a public option where states would opt out,” Sen. Ben Nelson (D., Neb.) said on CNN’s “State of the Union.”

This would give states more power to dictate health choices to their residents. We should be moving in the opposite direction by creating a national marketplace for health insurance. (See Duncan Currie’s piece today for more on that.) That’s not to endorse the public option — far from it. It’s just to say that a public option with an “opt out” for states might actually be worse than one that’s available to everyone. At least the latter leaves the door open for a future reform allowing people to purchase health insurance across state lines.



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