HEALTHCARE - Opt-In or Opt-Out for States

"Obama And Reid May Be Leaning Toward Opt-Out" by Jon Walker, Fire Dog Lake

Sen. Ben Nelson (D-NE) told Poltico that he felt Harry Reid (D-NV) and the White House were leaning toward a national public option with an opt-out:

Finance Committee Chairman Max Baucus (D-Mont.) briefed Nelson and other Democratic centrists on Thursday morning.

“I keep hearing there is a lot of leaning toward some sort of national public option, unfortunately, from my standpoint,” said Nelson, a key swing senator. “I still believe a state-based approach is the way in which to go. So I’m not being shy about making that point.”

Sen. Chuck Schumer (D-NY) has been pushing strong for a national public option (presumably his “level playing field” plan) with a provision that would allow states to opt out if they choose. Given how closely Schumer has been working with Jay Rockefeller (D-WV) on the issue of the public option, I assume Schumer’s personal push for the opt-out compromise played a large part in Rockefeller’s public expression of tentative support for the opt-out.

Many important questions about the opt-out idea remain to be answered. What kind of national public option would it be (negotiated rates or rates tied to Medicare)? How would states opt-out (decree by governor, pass a bill, popular vote by state legislature, state wide referendum, etc.)? How soon could a state opt out (right away or not until 2013)? What would a state need to do to opt back in if it previously opted out? Who will pay for the added cost of states opting out?

Depending on the answer to these question only a few states might opt out, or over half the people in this country might be denied access to the public option.