The Lethal Politics Of The Opt-Out Public Option, Ctd

A reader corrects another:

In your most recent reader post on the opt-out provision about the public option, your reader is wrong:
"Furthermore, even if the entire state legislature and governor are philosophically against a national insurance plan, it's a very different thing to turn down a benefit that your state residents are already paying federal taxes to support.  Let's be clear: You cannot opt-out of the taxes to support the program. You can only opt-out of the benefits."

As anyone who is paying attention knows, the public option will not be supported by tax dollars, but by premiums paid only by those who choose to enroll. This is a central point: the public option isn't government care, but a government insurance program, run like any private insurance company. While premiums for low-income individuals might be subsidized with tax dollars, this will be true whether the premiums are paid to the public plan or a private insurance company, and the debate over whether we should subsidize insurance for the poor is entirely separate from one about the value of the public option.

That doesn't mean that the opt-out, as currently envisaged, is framed fairly. Another reader notes:

I like your version of the opt-out strategy and results, especially the idea of Republicans having to argue against this cheap and effective plan for their members. However, if the legislative language in the bill reported out of SFC is any indication of where they are headed with the opt out...then you need to consider this: Under the legislative language in the bill reported out of the SFC, a state would have to apply for a waiver from the Secretary of HHS in order to "opt-out" from any or all parts of the bill. To be granted a waiver (or opt out) from any or all provisions of the bill, the state would have to achieve nearly impossible benchmarks:

the state has a comprehensive and detailed plan to meet the requirements of the waiver, the plan will lower the growth of health care spending, improve the delivery system performance, provide affordable choices for its citizens, expand protection for excessive out of pocket spending, provide the same level of coverage the same number of uninsured as would have been covered by the implementation of the bill in the state, the plan will not increase the federal deficit the state will provide a 10 year budget plan for the waiver.

This isn't an opt-out at all. It's frankly a nearly impossible standard to meet. And, even if a state did meet the standards iterated above to be granted such a waiver, it would have in essence promised to fulfill the intent of the law anyway.

It should also be noted that this opt-out currently applies to the entire bill and not to one provision or obligation. I understand the legislative language will likely change significantly from what was reported out of committee and what will be the final product that will land on the floor of the Senate may contain just a whiff of the above language. But for the sake of argument, the current opt-out language is not truly an opt-out. it's an Opt Out in Name Only.

My horse sense says that the false choice alone will empower and infuriate opponents of the public option, not do them in. Personally, I hope the Dems are as crafty as you think they are and that the language will be retooled to let the Republicans be hoisted on their own petards as it were.

It's all still in play, and Schumer is the one to watch. Legislating is fun, innit?