The difference with the progressive push for it one a Federal level is commercial private insurance is also available in the three states that have it….
Polling shows that most Americans want both available to the public….
Colorado Gov. Jared Polis on Wednesday signed into law a public health care option, making it the third state in the US to approve the creation of a government-run health insurance plan to be sold alongside commercial coverage on the Affordable Care Act’s insurance marketplaces.
More than a decade ago, a federal public option was cut out of the ACA, largely because of objections by centrist Senate Democrats. Now it’s enjoying a revival of sorts. President Joe Biden campaigned on a public option in 2020, and while the chances of his proposal (or something like it) passing at the federal level have faded, Democrats in Congress are seeking input on what a federal public option should look like.
But some states aren’t waiting for Congress to act. Their public options may be more limited than what a possible federal version could be, but they are still valuable experiments that will test the concept in the real world.
Washington state first approved its public option in 2019 and made it available to consumers for enrollment in 2020. The state now has a year of experience getting the Cascade Care program up and running, and it’s already starting to tinker with the policy design. It’s also offering lessons for Colorado and Nevada (the other state to pass a public option this year, one week before Colorado).
As these states have drawn up their plans, one thing has become clear: The potential value of a public option is in keeping health care costs in check by keeping rates lower than those of private insurance plans. But it still remains to be seen whether a public option can expand health coverage to more people.
Already, more than half of the uninsured in the US are eligible for either Medicaid enrollment or ACA subsidies for private coverage. Surveys have shown that price concerns often keep them from enrolling — so if these public options can help put a check on rising health care costs, perhaps they can also have an effect on coverage. But that is an open question at this point….