It seems like even the mention of a “public option” right now is enough to bring some people to blows; okay, maybe not, but at least tense sneers and a few choice words under one’s breath. But what if there was another way? What if the public option was really “public” as in publically decided?
Currently floating around Congress is the idea of a robust public option with an opt-out clause, not on the individual level, but at the state level. This could either be done by a legislative action or by popular vote. Below are some reasons why this idea is awesome:
– It would appease the Conservatives who are all about state rights while also appeasing Democrats who want the public option. It would also quiet Blue Dog Dems who say that a public option is too politically dangerous for them back in their home states.
– Back in the day Medicaid came with a similar such clause, and you know what, every state has offered Medicaid since 1982 (Arizona was the last hold-out) and no state has ever dropped out.
– If the public option is the default decision and the state would have to opt-out, behavioral economics tells us that most states would do it (default preferences are extremely powerful).
– Even in states that do opt out of the public option, the fact that voters could presumably elect later to restore it creates an extremely credible threat to the private insurance industry that will itself help to create price competition (FiveThirtyEight.com).
– If the public option indeed reduces the costs of insurance — and most of the evidence suggests that it will — then the states that opt out of it will have a pretty compelling reason to opt back in after they see the effects in neighboring states.
– And if for some reason costs do sky-rocket (even though it would give the government a pretty good advantage of scale in addition to Medicare/Medicaid for negotiating prices, etc), the opt-out clause would be a relatively painless way to do away with the public option.