Opt Out Public Option

Senate Majority Leader Harry Reid's latest incarnation of "health care reform" includes a public option-- i.e., a governmental insurance plan for the uninsured.  But it also includes an "opt out" provision that allows the individual states to refrain from participating. 

The appearance created by this proposal is one of flexibility and federalism and allowing creativity and innovation at the level of the states.  It gives the illusion of reasonableness.  However, the truth is a bit different than the appearance.

From the Heritage Foundation:

1. States could only op-out of the public plan, not of the entire bill.

This is only an “opt-out” of one section of the massive health care proposal. There are literally hundreds of provisions that the states may find unacceptable, like the costly Medicaid expansion...

2. A state opt-out does not eliminate the public plan.

The federal government would likely require the any state wishing to opt-out to still meet federal conditions. It could come, for example, as an explicit requirement that a state set up a public plan “option” that mirrors the federal public plan or as a public plan masquerading as a “co-op” that is in effect controlled, funded and accountable to the government...

3. Experience shows that a federal public plan would likely be the easiest option for state officials.

With the typical bureaucratic red tape and administrative complexity accompanying a state opt-out, states would likely discourage states from opting-out. Moreover, the federal strings that follow would likely strangle states ability to administer an option that does not closely follow the federal public plan model.

Crushing State Innovation.

The massive bills in the House and Senate- with individual and employer mandates, federal control over health insurance benefits, new boards and commissions micromanaging what taxpayers get or don’t get, new fees, taxes and insurance costs- is a challenge to the citizens of the states. Bright and innovative state officials would prefer to embark on their own reforms, but these bills would crush creativity, innovation and experimentation under the weight of federal control and conformity.

There is one other aspect of this issue that is very important.  States would feel a competitive need to participate in the federal program rather than opting out-- if it was a true opt-out.  Why?  Because some employers will be eager to dump their employees on the public plan, and would be less likely to locate in a state that does not offer that alternative.

In summary, very few states would likely opt out; and those that do may find themselves facing draconian requirements imposed by the federal government. 

"Opt out" is not all that it is cracked up to be.

Comments

[cpa101]

I also see having states in charge of any type of public plan as another version of the extortion that goes on with highway funds. I expect any public plan will be administered by the states whether it is the actual public plan or some opt out plan that is up to federal standards. Once this happens and the states are on the hook to the feds for the money to run the program then all types of requirements will be piled on regardless of the ties to healthcare.
Think of the increase of the drinking age to 21 as an example. What does this have to do with highway funds? The feds extorted the states by threatening to withhold the revenue stream in that case.

[bubba]

All this "new and improved" health care nonsense shows that nothing has changed.

"Transparency in government" now means that we can easily see right through the Democrat/"Progressive" obfuscation on issues like this.

[bubba]

"I also see having states in charge of any type of public plan as another version of the extortion that goes on with highway funds."

Good point, cpa. The Feds have been doing that sort of thing since the 70s, when they used the tactic of withholding funds to states who refused to comply with the 55 mph national speed limit.

[bubba]

Marianne Suarez at Civitas says it's not a "public option", it's a "public compulsion".

http://civitasreview.com/healthcare/opt-out-%E2%80%A6unlikely/

[Stormy]

San Fran Nan says it is the "consumer" option. Debbie Wasserman Schultz calls it the "competitive" option. Yeah, right. Fun with words to misdirect people.

The next thing we'll see is one of the politicians try to give it a new moniker, using the old Dixie Walker line of it being "The People's Cherce".

In any event, as Rick Moran said: "I think the old saw about dressing a pig in a prom dress will still leave you with a well dressed porcine is apt here. Even if you put a goat's head on the pig, you won't change its nature."

[Joe Guarino]

cpa, I agree with you. The national Democrats do not write 1500 page bills to let states do what they want.

Bubba, I think we are seeing a clever use of language to make the national Democrats' work product appear to be much more benign-- and much more optional-- than it will actually be.

Stormy, you speak of pigs. I think if the Democrats pass their bill, we will be fairly envious of the veterinary care pigs receive.:)

[Dr. Mary Johnson]

The "clever" use of language is not so clever, Joe. And it's really pxxxing me off.

North Carolina actually offers some of the best veterinary care for pigs in the world.

Before we eat them.

[Joe Guarino]

Mary, we are justified to be a bit annoyed by the ploy that Reid is attempting. Fortunately, as the media has reported yesterday, there is a significant number of Democratic senators who are not buying into the public option.

The question is what Reid does next. Does he take the public option out of the bill, thereby risking the support of other Dems who demand the public option? Or does he go the reconciliation route with the public option (assuming he has 50 votes)?

And what other compromises will he need to make to get the number of votes he needs-- and will he be willing to make those compromises?

[Brenda Bowers]

So far 19 state legislatures are passing or writing legislation to counter the power grab by the federal government. Blue Dog Democrats are finally beginning to see the light. Health care reform is on its last legs IMO. So is Cap & Trade. Far more troubling is Obama's declaration this past Friday night of a national emergency which gives him almost unlimited power. Watch for it. BB

[Joe Guarino]

Brenda, let's hope he is not creating an emergency intentionally so that he can wield emergency powers.\

The health care bill is going to create a number of interesting constitutional questions-- not the least of which is the federal government usurping state powers and prerogatives.

[Stormy]

It's pretty pathetic when children are used to peddle government entitlements. If there are 8 million uninsured children, my question is "why?". This country entitles millions of poor children to health care through Medicaid. If those 8 million children are not members of poor families, then why do their parents not have health insurance?

http://www.youtube.com/watch?v=mkDhKHD52tk&feature=player_embedded

[Joe Guarino]

Stormy, from a technical standpoint, that is a very effective ad. But as you suggest, it raises all kinds of questions.

One could just as easily craft a manipulative ad that dramatizes how the cost of health care reform-- in combination with the other entitlements-- will fall most severely on the young; and how we are effectively borrowing against their future, laying them down with nearly insurmountable debt.

[Stormy]

Joe, my point is that it is pathetic to use children to sell a political message. It's the same thing that is being done using children to sing the praises of Obama. It's the same thing that totalitarian states do, such as North Korea signing praises to the Dear Leader. It's propagandizing children. Is there any doubt that they will grow up to believe in government-provided entitlements? Where is the balance for children?

[Joe Guarino]

We need to remember, Stormy, that 40% of these kids are being born into single parent families, so a large number will already be on Medicaid and SCHIP's style insurance. A large number will grow up believing in government provided entitlements, especially here in North Carolina. That is not a good sign for the future.

But your point is well taken about the propaganda-like aspect of using children by Obama, the national Democrats and their supporters. Of course, it is not entirely new. Rhetoric involving children has been used to expand government for a long time.

[Stormy]

Joe, that is right. How much of the taxpayers' money has been pumped into our left-dominated public schools using the old saw of "It's for the children". Any time someone says that to me, I automatically say "NO".

[Bubba]

Why do you hate children and natural science, Stormy?