Senate Majority Leader Harry Reid, D-Nevada, came out yesterday for health care reform that includes a public option with an opt-out provision for states that don’t want to participate — a compromise that should get blue dog Democrats on board.
However, it seems there’s no pleasing some people when it comes to prodding health insurance companies with even a modest dose of competition and giving hard-pressed Americans a break.
As the proposal Reid backs stands now, only a small portion of the 47 million-plus without health care insurance would be eligible to sign up for the public-option plan, even if every state were to participate. In the likely event most red states opt out, the pool of public-option insureds would be severely reduced, setting the program up for failure from the start.
But there’s another angle to an opt-out plan that no one is talking about.
What better way for red states export lower-income, ailing, needy people to blue states? This has gone on for decades because blue states like New York, New Jersey, Illinois and California offer more and better public assistance in various forms. Adding the opportunity to gain access to public-option insurance would only add to the inequity among states.
It’s one thing for, say, Pennsylvania taxpayers to ante up the money for welfare, child care assistance, job training, etc., for their fellow Pennsylvanians who are in a bad way. It’s another thing for them to have to also take on the burden of a few thousand arrivals from the Carolinas, Kentucky and Tennessee.
With an opt-out provision for health insurance, don’t be surprised if more-generous states find themselves burdened with anywhere from a few dozen to thousands more needy red-state refugees.
Generating that kind of unfairness is the last thing a federal program intended to help millions of people should do. Furthermore, it creates a disincentive for any state to be more generous with public assistance than most red states are.
Maybe on balance it’s worth incurring this inequity because a public option for health insurance is needed so badly by so many. But no one should kid themselves about the opt-out approach being a benign or win-win proposition. Clearly, it’s neither.
The Blue Dog Democrats will be rubbing their hands at this opt-out proposal, they can vote for it knowing full well their State leaders won’t even look at it. Pathetic.
Your Health Care Refugee point is a good one, the towns around state lines can expect new residents, what a mess that will be.
This bill is like reading a book that keeps changing half way through every chapter, the plot, the list of characters, protagonist, antagonist, and the ending seems further away.
I think it’s time to alter one of my least favorite sayings: The greedy is the enemy of the good.
Holte, that’s the funny thing about it. Follow the link in my post and you’ll see they’re still critical and unwilling to commit to supporting Reid’s proposal. What we need at this point is a president willing to spend some political capital, who makes it clear to blue dogs he’s taking names and making his 2010 campaign plans.
Good one, Randal. That’s borderline profound.
This proposal is dead…either from the start or soon after implementation. With opt-out in place, the program practically guarantees that it will lack the leverage necessary to do anything about health-care costs. In the end, it’ll be just another expensive band-aid which does nothing to change the status quo.
I’m in favor of opt-out, but only because it’s probably the only way to get the public option passed.
But that is a valid concern that you expressed. The red states will get redder and the blue states will get bluer, as people with low incomes or pre-existing conditions move to the blue states.
I think opting out would take a statewide referendum, and not just the governor and/or state legislators deciding “no, we don’t want it.” A referendum would be more difficult and take longer.
I want single-payer, dangit!!! Not going to get it, but a bee can dream.
I gotta tell you, I have my reservations also. While I want the door open for more meaningful legislation down the road, I also would like to see something actually useful.
Now I’m hearing that the public option is off the table again. I haven’t confirmed this yet but if true then there is no healthcare reform.
I’m liking the British style system more and more. Make the whole thing non profit.
Hi, Kvatch. I wish I could say your negative outlook isn’t justified. Alas, it is justified.
Tom, I hope a referendum would be required but wouldn’t bet money on it. A referendum would benefit pols like Gov. Mark Sanford because they wouldn’t have to come off as bad guys for saying no to the public option. But in a few states, a referendum might stand a chance of passing on a referendum vote, whereas the governor and legislature of those states would surely reject it.
Still, checkerboard programs and benefits make for bad public policy.
Bee, there should be some defined point of watering down past which liberals and moderates who support a real public option say it’s no longer worth passing. Come back to it next year or the year after, if need be. In the meantime, absolutely haunt Republicans and bluedogs night and day, day in and day out, for having killed health care reform. Demonize them the way Republicans demonized all Dems as “tax and spend liberals” back in the 1980s. Think of it as softening up the beachhead before the troop landings begin. Make a public option plan a key issue in the 2010 elections, telling voters if you want it, you’re going to have to elect more Dems and un-elect more Republicans.
Demeur, what those aligned against a decent public option and other reforms fail to reckon with is the sealed-teakettle effect. They could easily be setting themselves up for having the whole issue blow up in their faces later on, when people are so fed up they demand not baby-steps reform, but revolutionary reform. That revolutionary reform would probably be single payer or universal Medicare.