LYNWOOD, Calif.—The dozen elementary- and middle-school students who were practicing calisthenics, before they began a class on healthy eating, surely had no idea they were at the forefront of the debate over the future of health care in America. But the young people who gathered here last week for the Healthy Cooking for Kids session at the Lynwood Family Resource Center are part of what may be the country’s most thorough test in establishing a public competitor to private health insurance.
The Lynwood Center in this predominantly Latino neighborhood southeast of downtown Los Angeles is operated by the L.A. Care Health Plan, the nation’s largest public health-insurance company. L.A. Care was launched in 1997 by the state to manage the health care of Los Angeles County participants in California’s Medicaid program, known as Medi-Cal. But since 2013, it has also sold insurance to the general public through the state insurance exchange established under the Affordable Care Act. In the process, L.A. Care has directly competed with private health insurers for customers, exactly as many Democrats want a “public option” to do nationwide.
“The only income we get is the premium income,” John Baackes, L.A. Care’s chief executive officer, told me. “We don’t get a subsidy; we don’t get any special treatment; we have to go through all the same regulatory hoops that [private insurers] do. So I’m saying, ‘If you want to see what a public option looks like, come take a look.’”