Obamacare

Public Option II: Public Optioner?

|

Are we set for a sequel to last year's debate about the "public option"—a government-run insurance plan that liberal members of Congress and the progressive base wanted added to the PPACA? Ultimately, the provision was given up in a bargaining manuever by Democratic leadership and the Obama administration, but The Washington Post reports that 128 House Democrats are trying, once again, to light the public option fire:

At a time when both political parties are worrying about the federal deficit, an unexpected and unorthodox proposal is coming back from the shadows of last year's health-care debate the "public option." The idea of creating a major government health insurance program was roundly rejected last year, but the 128 House Democrats pushing to reconsider the idea are now advancing the argument that it would help hold down federal spending.

Their bill, which faces long odds, would allow Americans who do not get insurance at work to choose a government plan for their health coverage starting in 2014.

"There is all this concern about the deficit," said Rep. Lynn Woolsey, D-Calif., a leading champion of the proposal. "Well, guess what, this would reduce the deficit because it saves so much money." Woolsey and her allies, including Reps. Jan Schakowsky of Illinois and Fortney "Pete" Stark of California, are armed with a new analysis by the nonpartisan Congressional Budget Office. It projects the public option could save the federal government $68 billion between 2014 an 2020, according to Democrats.

There are two things going on here. The first is that there really are a lot of liberals, both in the House and within the activist base, who remain deeply upset over the health care bill's failure to include a government-run insurance program. That core liberal group is going to take every opportunity they can to raise the subject. The primary thing that's going on here, though, is that many Democrats are eager to needle Republicans about the deficit. It's a game of pick-which-is-worse: Republicans have been loudly worrying over the deficit recently (though without supporting any particular deficit-reduction mechanisms), and Democrats want to put the GOP in the position of having to choose between their worries over the deficit and their hatred of government-run health insurance.

In other words, this isn't a serious attempt to reignite the public option debate, especially since Democratic leadership is probably not keen to start the health care battle again so close to the elections. But that doesn't mean that the public option is dead forever. As Rep. Henry Waxman, who chairs the House Energy and Commerce Committee, noted in April, the idea will definitely come back should the PPACA's insurance exchanges fail to produce the desired results. Given the troubles Massachusetts has had with its insurance market in the wake of its health care overhaul—and, in particular, given the significant premium spikes we've seen in the state—I suspect that it won't take long after the exchanges are put in place for Democrats to revisit the issue. But the on-switch for the exchanges won't be flipped until 2014, which means that the public option fight is destined to be a long one. In the meantime, what we're seeing is mostly just petty political gamesmanship. 

NEXT: The Vault of Legislators

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. the 128 House Democrats pushing to reconsider the idea are now advancing the argument that it would help hold down federal spending.

    I do believe that I predicted this yesterday.

    [takes bow, adjusts monocle, sets top hat to a jaunty angle]

  2. “Well, guess what, this would reduce the deficit because it saves so much money.”

    Well, sure. If you just start denying care to people and not paying for it, you certainly “save money.”

    Fuck these fucking disingenuous fucks.

  3. In the short run, I think a public option could actually be a step back in government intervention in the health insurance sector.

    If the government would allow private health insurance to do its job, then provide a public option to handle those individuals who simply couldn’t fit within the system, health care costs for individual consumers would drop, and the government would probably get away with spending less money than they do subsidizing the attempt to shove everyone into the current system.

    The question is, though, whether instituting a public option would constitute another ratcheting of government power and would simply lead to even higher future growth in government control over health care.

    1. This could only work if the government created a parallel health care apparatus to the existing one. If they created a public option on top of the semi-free market we currently have, it would simply distort the market even further.

      If the gov’t created a separate system, it would be obvious that it provided poorer quality care at a much higher price.

      1. If the gov’t created a separate system, it would be obvious that it provided poorer quality care at a much higher price.

        “if”? VA, Medicaid, Medicare — any of those systems superior to private care?

  4. Also, the public option could be looked at as direct, visible government control over the health care industry. Currently the government spends so much on health care and regulates so much of its provision that we have no clue just how much government interferes.

    I at least prefer government I can see and monitor than one that operates secretly and often chaotically.

  5. But that doesn’t mean that the public option is dead forever.

    Indeed not. I set the over/under on a public option at 5 years (the session after the next mid-term Congressional election). Here’s the scenario:

    Health care reform has devastated private insurance. Millions have been added to Medicaid. The health insurance exchanges are close to collapse due to adverse selection. The Republican Congress has sustained its traditional mid-term election losses, and the Dems now run the show (again).

    Ergo: Public option.

    1. Don’t forget the constant explanation that the health insurance companies themselves failed the public, not government.

      I just wonder how insurance companies will adjust to accommodate a public option. All of that capital investment is not just going to evaporate, and congress is not going to put them out of power, as most of the leading congressmen on this will be counting on lobbyist positions in the future.

      1. I just wonder how insurance companies will adjust to accommodate a public option.

        My guess is they will shed their health insurance risk business (where you take in premiums and pay out claims), and go into the third-party administration business, with a focus on administering the public option.

        1. i.e. Medicare.

  6. Congress to the US public:

    Take care of THIS!

    1. Thanks!

  7. This has kind of a Thelma & Louise vibe to it.

  8. Public Option II: Health Care Boogaloo!

  9. Health care reform has devastated private insurance. Millions have been added to Medicaid. The health insurance exchanges are close to collapse due to adverse selection. The Republican Congress has sustained its traditional mid-term election losses, and the Dems now run the show (again).
    I just wonder how insurance companies will adjust to accommodate a public option. All of that capital investment is not just going to evaporate, and congress is not going to put them out of power, as most of the leading congressmen on this will be counting on lobbyist positions in the future.

    David Mayer

    geo tv live

  10. OK it actually makes a LOT of sense when you think about it.

    Lou
    http://www.privacy-tools.be.tc

  11. “Well, guess what, this would reduce the deficit because it saves so much money.”

    Well, I’m convinced.

    1. You’ve gotta spend it to save it.

      1. Or maybe it’s the other way around? Who cares? Which way to the next Senate reception?

  12. I am sure the Whitehouse is just dying to talk about the public option and reopen health care again. These numbers are brutal.

    Democrats will be gulping this morning at the Quinnipiac Poll’s latest results. For the first time in the survey’s history, Americans believe by a 48% to 40% margin that President Obama doesn’t deserve re-election. Almost as stinging, a plurality believe the country would have been better off if John McCain had beaten Mr. Obama in 2008.

    The Quinnipiac Poll is pored over by political observers because it has a good predictive record and because its large sample size of nearly 2200 people implies a much smaller margin of error than most surveys — around 2 percentage points.

    Peter Brown, assistant director of the Quinnipiac University Polling Institute, says the warning signs for Mr. Obama include the fact that voters now turn thumbs-down on him on all major aspects of his presidency. Only 39% rate him positively for his handling of the economy, only 43% on foreign policy, a mere 30% on his illegal immigration stance and only 41% like his Gulf oil spill policy. Even his pick of Elena Kagan for the Supreme Court is approved by voters by only 46% to 34%.

    http://online.wsj.com/article/…..TopOpinion

  13. Woolsey said she is willing to wait. “This will be there for the next Congress,” she said.

    Out of Touch

  14. Um…

    The fact that it will save money is simply a testament to how bad the current legislation is! If viewed against the system before the current health care legislation was passed, they could NEVER claim it would save money.

    So, that’s like a retail shop increasing prices 50%- then selling a membership that get’s you 30% off everything in the store! Look at how much you’ll save!

    1. They claim everything will save money. The last thing was supposed to save a bunch of money. Medicare was supposed to save money. I can claim my bill does anything I want, provided I can give the CBO a bunch of assumptions to work with that will give the desired output.

  15. “Well, guess what, this would reduce the deficit because it saves so much money.”

    Seeing how the Medicare unfunded liability stands at $38 trillion, I can see how this will save us even more money, since we’ll never pay for it anyway.

  16. We already have the public option in the form of Medicaid. You just have to be broke enough to qualify for it. And I’m sure there are people who decide they are better off being broke enough to qualify for it, to get it, and there will be even more of them after the insurance mandate has taken effect.

    1. What I mean is that it really is a serious option as many people must look at it.

  17. At a time when both political parties are worrying about the federal deficit . . .

    Hahahahahahahahahahahahahahahahahahahaha.

    Whoever wrote that should look in to a career as a sitcom writer or standup comedian.

  18. I suspect that it won’t take long after the exchanges are put in place for Democrats to revisit the issue.

Please to post comments

Comments are closed.