JONATHAN CHAIT JULY 22, 2010
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Liberals did not get a public option in the Affordable Care Act. But that doesn't mean they never can. Indeed, they're introducing one already:
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.
Jonathan Bernstein has been making this case for a while. If liberals continue to organize around the idea, they can make it a part of party doctrine and secure pledges to support it from candidates for office. Democrats who oppose the public plan are going to have to come out and admit they oppose it, instead of hiding behind the opposition of others. It's a popular idea and eventually they should be able to get it enacted. "Eventually," of course, could be two or three decades.
5 comments
So Jonathan, deficit-obsessed conservatives should find the public option extremely attractive, right?
- liberal reformer
July 22, 2010 at 10:21am
Hooray for political grandstanding! Let's just avoid some of the biggest weaknesses of current health care law -- 1. That health insurance isn't made affordable enough -- particularly for those with chronic conditions who will hit the out-of-pocket cap every single year (i.e., someone with HIV) 2. That insurers are given too much flexibility to design benefit packages and price people out of health insurance 3. That there isn't enough restriction on employers selecting against the Exchange or individuals waiting until they get sick to purchase health insurance. These good progressives should know better. They've only had, oh, a year, to think about these things. ...
- jimbomoron
July 22, 2010 at 10:52am
Wait a minute -- you mean there's something even more liberal/commie/atheist/socialist/evil out there than the HCR law? That can't be -- I have it on good authority from M. Bachmann, S. Hannity and a little organization called THE TEA PARTY (maybe you've heard of them?) that Obamacare is as end-of-this-nation-as-we-know-it as it gets.
- W_Bombay
July 22, 2010 at 12:14pm
How about throwing in Medicare buy-in at 55 for good measure, which would further reduce costs by shoring up Medicare finances?
- timteeter
July 22, 2010 at 2:20pm
The Medicare buy-in is a bad idea. Any time you break down the firewalls between employer-based health insurance and another system, and have equal tax incentives, you have a recipe for anti-selection. If you break down the insurance firewalls, it's easy to see employers ratcheting down coverage to the minimum standard, and telling their sickest employees that if they want more coverage, they should go to Medicare (or the Exchange). Let's focus our attention on making health care more affordable to everyone -- particularly those with chronic medical conditions (i.e., HIV) -- rather than who does the paperwork.
- jimbomoron
July 22, 2010 at 2:33pm