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Go Home Who Triggers the Public Option?

THE PLANK OCTOBER 12, 2009

Who Triggers the Public Option?

The progressive zeitgeist during the last week has leaned pretty strongly in the direction of a health care reform system that would provide for a strong public option that states could either opt into or opt out of, as opposed to a "triggered" public option where, in theory at least, objective market conditions would determine what happens in particular states. 

Interestingly enough, one of the Democratic senators considered shaky on health reform, Bill Nelson of Florida, said today that he favored the "trigger" over any state option.  When you look at the state Nelson represents, you can perhaps understand it.   At present, Florida has a Republican governor and a Republican-controlled legislature, and is facing a highly competitive 2010 election cycle.  (For the record, I've been raising my own alarms about the impact of a state option on the dynamics of the 2010 elections at the state level).

Why isn't this point of view held more generally?  It could be because the "trigger" idea emerged earlier than the various state option schemes, so that insistence on an "untriggered" public option became part of the general campaign against abandonment of the public option altogether.  Or it may be because many progressives, citing polls, think the public option is so popular that resistance in the states can be overcome. 

I don't quite understand why anyone would assume that state legislatures are more resistant than the U.S. Senate to the blandishments and threats of the forces opposing the public option, but it's a legitimate argument in a debate that really needs to break out among all advocates of health care reform.  Barring a "robust" national system, the public option is in fact going to be "triggered" in parts of the country one way or another.  The question is who or what does the "triggering," under what sorts of circumstances. 

This item is cross-posted from The Democratic Strategist, where Ed Kilgore is Managing Editor.

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I think the opt-out system is fine, as is the opt-in. Let the southern states get reamed by the insurance companies as Northern and Western states gain the advantage. The blue states that will be part of the public option will represent a huge segment of the population, more than enough for economy of scale. Long term, businesses in the southern states themselves will start to clamor for a public option themselves, or they will stop providing insurance, either case the Republicans will be grasping for any rationale as to why their strictly market based approach ain't working. And if the red (neck) states remain recalcitrant, well, frankly no one is forced to live there and the people can vote with their feet.

- blackton

October 12, 2009 at 7:26pm

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Good point, blackie, nothing will finally lay bare to those not-upper class voters that they vote against their interests and that there is indeed something very wrong with Kansas. The worry is that, since reform will not be in play until 2013, until then, it's entirely an issue that can be packaged as poisonous liberal fascist witchcraft and sold to the tea party/Limbaugh/Beck subset. If the Congress changes hands in 2010 as a result of such a campaign, it will be difficult for Obama to make yearly budgets that will provide for HC reform tenable. Incremental the approach must be.

- dylanposer

October 13, 2009 at 8:57am

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