Public Health Insurance Option At Risk Right Now

There are now a few key dynamics jeopardizing the inclusion of a public health insurance plan in the Senate Finance Committee’s final bill. First, is that many of the champions of progressive health care reform are being pressured to work for a bipartisan, and less effective reform package. The pressure on the hill to push a plan with bipartisan support is gaining traction. And there is a real danger that passing a bill that everyone in the U.S. Senate can support could take precedence over enacting a law that everyone in America needs.

The second dynamic is a proposal that would establish a “trigger” for the creation of a public health insurance plan (a public health insurance plan would only be established if an arbitrary measure of market concentration were hit in a state). This would reduce the public health insurance option from a national plan with the capacity to make big improvements in how we deliver care to a series of fledgling state plans, developed in isolation and only when a state’s insurance market is in desperate shape.

Unfortunately, the “trigger” proposal is smart politics, and could provide an artificial “third-way,” allowing members to vote for a public option that will either never be created, or be created only under adverse conditions (on a state-by-state basis) that would increase the likelihood of its failure.

We simply cannot allow a public option with a trigger to make it out of committee. We need to talk with our state Senators (and ask Senators to talk to other Senators) and make it clear that a reform bill with a public option that’s held back by a trigger is not a reform bill it all. It’s simply a way to capitulate to the politics of the day and squander the historical opportunity to make a lasting difference.

The heart of the HCAN strategy is unity between the President, Congress and the progressive base. If the Senate Finance Committee were to pass the trigger it would fracture that unity, forcing us to focus resources on a fight in the Senate, raising people’s doubts about reform and diverting us from reform’s enemies.