HEALTH REFORM: Too Much Spotlight On The Public Option?

November 2, 2009 - 10:41am

In the health care debate, the public option frequently takes center stage. But, according to the latest CBO estimates for the House health reform bill, all that attention may be unwarranted. The numbers are in -- the public option in the House bill will likely cover only two percent of Americans (around six million of those under 65) by the time it is fully implemented in 2019.

This low estimate shows that the public option will likely be a small "niche" operator, reports the AP, and that House leaders have designed the public option to accurately target those who have difficulty acquiring private coverage, but are not eligible for Medicare or Medicaid. The public option will be available to those working in small business or individuals seeking to buy coverage on their own.

The CBO projects that those who are less healthy will probably be attracted to the public option because of more relaxed rules about accessing specialists and medical services, reports the AP. Taking on higher risk patients will likely make public option premiums higher than private coverage -- so most consumers will seek private insurance -- and a massive exodus from private coverage is unlikely.

The fuss over the public option has left other key issues waiting in the wings, Kaiser Family Foundation president Drew Altman told the AP,

The public option is a significant issue, but its place in the debate is completely out of proportion to its actual importance to consumers... It has sucked all the oxygen out of the room and diverted attention from bread-and-butter consumer issues, such as affordable coverage.

(Actually, President Obama has tried to make the same point...)

The CBO estimates show the public option is on the right track to do what it was intended to do in the first place -- compete on a level playing field with private insurers. We can hope this estimate will mean everyone can relax (including certain worried centrists), stop panicking about the public option, and move on to the other issues that we need to resolve to bring about comprehensive high quality health reform.

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