Dems Discussing Public Option With Opt-Out Clause: The Silver Bullet?

[KoKo]

Sam Stein
[e-mail] | HuffPost Reporting
Dems Discussing Public Option With Opt-Out Clause: The Silver Bullet?

Senate Democrats have begun discussions on a compromise approach to health care reform that would establish a robust, national public option for insurance coverage but give individual states the right to opt out of the program.

The proposal is envisioned as a means of getting the necessary support from progressive members of the Democratic Caucus -- who have insisted that a government-run insurance option remain in the bill -- and conservative Democrats who are worried about what a public plan would mean for insurers in their states.

"What folks are looking for is what gets 60 votes," said a senior Democratic Hill aide. "The opt-out idea is very appealing to people. It has come up in conversations. I know personally that a handful of members have discussed it amongst themselves."

In conversations with the Huffington Post, sources have said that while the opt-out approach to the public plan is in its nascent stages it has been discussed with leadership in the Senate. It was pulled out of an alternative idea, put forth by Sen. Tom Carper (D-Del.) and, prior to him, former Senate Majority Leader Tom Daschle, to give states the power to determine whether they want to implement a public insurance option.

But instead of starting with no national public option and giving state governments the right to develop their own, the newest compromise approaches the issue from the opposite direction: beginning with a national public option and giving state governments the right not to have one.

"It is being discussed," said one progressive strategist who has been working on reform with both the White House and Congress. "In the end obviously, the goal and near-term exercise is to get to the bargaining table and get to the conference committee between the Senate and House with the strongest position possible."

How such a system would work is still being debated, according to those with knowledge of the proposal. But theoretically, the "opt-out" approach would start with everyone having access to a public plan. What kind of public plan isn't yet clear. States would then have the right to vote -- either by referendum, legislature, or simply a gubernatorial decree -- to make the option unavailable in their health care exchanges.

For conservative Democrats -- especially those from states with major private health insurance industry interests -- this concession could be key, allowing them to punt a vote on a public plan to local governments. For progressives, it would not be the hardest pill to swallow.at:

"It is clearly much better than triggers and opt-ins," said Richard Kirsch, executive director of the group Health Care For Americans Now. "A trigger option is a way to kill the public option and these opt ins are not effective because it leaves it up to state legislatures to set it up..."

Another Democrat working on reform legislation added, "If everyone gets a plan, and states have to affirmatively vote, preferably by referendum, to opt out. I really don't see a lot of states opting out, for one. And, for two, you get your national available everywhere. If a few holes start appearing, it's not nearly as fatal as if you went with the Carper plan, which after a few years might mean 10 or 20 public options. If you go the other way, you'll probably have like 47 states. It's a big difference."

Naturally, there are still major question marks about the opt-out approach. For starters, will all progressives be on board? With 60 caucusing members in the Senate, the argument has been made that the liberal wing of the party has already compromised enough to stop the Republicans from filibustering legislation. Moreover, the House of Representatives seems all but certain to pass legislation that includes a robust public plan. Would legislators in that chamber be willing to add a opt-out provision for the sake of picking up Senate votes?

More at......

http://www.huffingtonpost.com/2009/10/07/dems-discussing-public-op_n_313054.html

[lonestarnot]

1. What a bullshit idea.

[dysfunctional press]

3. of all the ideas other than single-payer or a complete and robust public option- this one seems best

let the stupid states wallow in their ignorance.

it could also spur growth in some states that keep it, as unhappy/sensible people from the stupid states migrate in.

[lonestarnot]

4. Well only if your state promises to take 1/3 of our ignorant.

[dysfunctional press]

9. each state is responsible for it's own decisions...

if you don't like your state's politics- work to change them or move.

pretty easy concept to grasp, actually.

[Oregone]

2. How would the mandate work with the opt-out?

Mandated private insurance, anyone? If this is even a possibility for ANY percentage of the population, fuck that.

[WCGreen]

5. It better be by referendum or else the lobying at the state Capitals

will be intensified and since state government is almost never covered by local news outlets, it could turn out to be a disaster for those who want the Public Option. What if the Government opts out could the people vote one in and what would stop the changing governemts to voting back and forth for perhaps a decade.

[customerserviceguy]

6. You'll see the sickest Americans

moving to the states that stay in for public option, and the opt-out states' private insurers will encourage this behavior.

[Uben]

8. Will they have too?

The way I understand it, they can still get on the national plan if their state opts out, thus, the national plan first, and then let the states that want to, opt out of sponsoring an exchange.

[Are_grits_groceries]

10. How are we going to move??

With what money? To what jobs?

Read through this: http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=6745712&mesg_id=6745712

[customerserviceguy]

12. You have a good point

but if someone is living in a low-wage red state, being able to live in a rural area of a blue state where you get medical care from a public option plan might be appealing.

During the Dust Bowl era, poor people moved from that place to California somehow. The same thing happened with poor African-Americans who left the South for factory jobs in the North.

Whenever the financial incentive is great enough, people will find a way.

[quaker bill]

7. The interesting bit

is that there are very few places where an actual "opt out" would be politically sustainable over the intermediate term. Once the public plan is in place elsewhere and people begin to report that it works, political pressure to get a government that will repeal any "opt out" measure that passes will be enormous. This could be an easy way to remove a vast sea of republican local office holders over the next two or three cycles.

[KoKo]

11. You think that could work? I'm worried that RW Repug Gov's would kill it all

and that would be the end of it. Well..what you say is an interesting thought.

[cliffordu]

13. Doesn't this open the door to those other 'states rights'

arguments that the slaver's wanted to keep, to opt out of federal law????