Arizona has a public option
Maybe I’m missing something. There’s an awful lot of talk about the public option being “back.” Ezra Klein explains the various opt-in and opt-out proposals. Olympia Snowe reveals that she will, in fact, oppose any public option despite earlier murmurings to the contrary.
But here’s what I don’t understand. Why can’t states that want public options just set them up on their own? Arizona, which is fairly red as far as states go, has a public option, and has had one for years. They “opted-in” before it was ever the subject of national discussion.
What gives? Why can’t all those blue states that want a public option, just set up a public option?
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“Why can’t states that want public options just set them up on their own?”
Money! The states would need federal funds to get this thing off the ground and operating for the first few years! Also pool size, states like NY have a big enough population pool to support a working public option, smaller states do not.
I would take a gander that the traditional/expected response from the left is that 50 public options is a.)inefficient b.) bad and c.) unaffordable for the states right now/ever.
That the public option would be large enough to be cheaper and more cost-effective.
Personally, I’m in the McArdle boat asking, what is the public option going to have to accomplish that goal that Medicare doesn’t, except fewer people?
With the caveat that business that find it cheaper not to cover their employees will end up dumping a few million in to the public option (too bad if you liked that insurance).
The opt out program seems like the stimulus approach to healthcare reform. “Sure you can opt out if your state legislature will turn down whatever amount of money is in this bill for them.”
The thing that seems interesting about the “opt-in” option is that it paves the way for regional public options, so Arizona, New Mexico, Utah, and Colorado could pull together. Tell me if I’m wrong but that would new, potentially competitive, and flexible. All things that don’t describe either our current system or many of the reforms likely to pass.
E.D. They can. And you are correct that Arizona has had such a program for awhile. The difference is that under Carper’s plan, the federal government will provide a lot of money to help the states get the programs together in the ‘opt in’ scenario. This could well motivate states, who are not having an easy go of it these days, to go with a public option while they have the opportunity of getting the federal dollars that will come with it. I do, however, think that the opt-out plan has more teeth, particularly in red states. It’s much easier to go with the federal program and let the state’s residents decide if they want it or not (on an individual basis.) The other problem with ‘opt-in’ is the intense lobbying that will occur on the state level by insurance companies seeking to avoid it.