Josh Marshall's take on the opt-out public option:
In two key ways the 'opt-out' flipped the political dynamics entirely. A big argument from Republicans was that the public option would force people into 'government health care' or in various other ways destroy the universe. The opt-out just says: 'fine, then don't allow it in your state. Next ...' That takes a lot of the wind out of the sails of that argument. And, more pointedly, conservative and moderate Dems who were afraid of voting for the full public option seem to think that this gives them sufficient cover to vote for it -- at least for the procedural 60 vote threshold, if not for the bill itself, which will take 50 votes. But that's all that's really necessary: getting past cloture.