The Public Option and the Future of ObamaCare


Here's a preview of ObamaCare battles to come: The Huffington Post notes that a group of House Democrats have revived calls to add a government-run insurance option to ObamaCare. The push comes in the wake of the fiscal cliff deal, which killed $6 billion in funding for non-profit health insurance cooperatives. Coop funding was included in the law largely as a way to quell liberal legislators unhappy that the law didn't include a full-fledged public option — a government-run health insurance alternative that would compete with the private health insurance plans sold in the law's health exchanges.

Given that Republicans control the House, these Democrats don't have any real shot at getting the bill passed. But it's likely an early shot in what's likely to be a long battle over how to manage health policy post-ObamaCare.

As parts of ObamaCare either fail to produce results or are stripped away, piece by piece, in budget deals, we're likely to see stepped up efforts to revise the bill in a more liberal direction. At the request of the Health and Human Services Department. some health insurers, for example, are proposing additional penalties be added to the law's health insurance mandate, which they argue isn't strong enough in the law's initial years. And in Massachusetts, the passage of a statewide ObamaCare-like program presaged a massive political showdown over rate increases in 2010 and years of increasingly aggressive calls for greater cost control measures — calls which last year resulted in the creation of a what is essentially a price control commission for health care in the state.

Indeed, the public option was conceived as a starter measure intended to pave the way for further liberal reform: Jacob Hacker, who popularized the idea of a public option, has been quite clear that the goal was to set up a government-run public option that would slowly grow into a single payer system — which would make it less a public option than a government-run monopoly.