The Affordable Care Act does not establish a national public option like many progressive would have hoped, but it does allow states to form their own public plans. Today’s Politico’s Pulse reports that Connecticut is aiming to do just that, and a new report from a state board to the General Assembly argues that such an option could save Connecticut taxpayers up to $355 million in 2014.

The option, called SustiNet, follows a 2009 state law which sought to use a publicly administered health plan to implement health care delivery changes designed to slow the growth of costs. Over the course of three years, the state hopes to expand the program from state-sponsored populations, state employees and retirees, to municipalities, private employers and families:

Effective on January 1, 2014, when most federal reforms become operational, SustiNet will offer comprehensive, commercial benefits to all of the state’s employers and households. This new health insurance choice will be available both inside and outside Connecticut’s new health insurance exchange, established under the ACA. SustiNet will undertake feasibility studies, develop business plans, conduct a risk assessment, and take any other steps needed to ensure that the new competitive option is viable and adds value in the marketplace. [...]

SustiNet will offer all employers and families a new, competitive health insurance option that reforms health care delivery and payment to improve value and slow premium growth. These reforms will spark broader change throughout Connecticut. Leading by example, SustiNet’s innovations will make it easier for others to follow a similar path. Our proposal harnesses the power of competition, ensuring that successful SustiNet reforms will be replicated by private insurers seeking to preserve their market share. SustiNet will also work collaboratively to implement multi-payer reforms that help the state’s providers give their patients high- value, quality care. And by enrolling a large number of consumers, SustiNet will gain the leverage it needs to reform health care delivery and payment.

Connecticut could serve as a test case for the progressive public option talking points we all heard so much about (and repeated) during the national debate. Indeed, Oregon and Vermont are already considering more progressive alternatives than what the ACA allows and if Congress passes legislation offered by Sens. Ron Wyden (D-OR) and Scott Brown (R-MA) to permit states that meet certain benchmarks to opt out of some of the requirements of the law by 2014 (rather than the current date of 2017), we could expect even more state experimentation on the horizon.

Time’s Nathan Thornburgh asks some smart questions about why 22-year-old Jared Lee Loughner, a man who was kicked out of his community college because of his mental state, passed a federal background check and was allowed to purchase the gun with which he killed six people and gravely injured 20 others:

Who else knew of Loughner’s mental illness? What obligations did his college have, and which ones did they fulfill, to report Loughner to other agencies? Most of all: Why is Arizona (along with other states) so far behind in reporting disqualifying mental illness to the federal background-check system? If there is anything that both sides should be able to agree on, it’s that unstable individuals should not have access to any kind of weapon, much less the so-called fourth-generation semiautomatic Glock 19 that Loughner bought. This time, the price for bureaucratic torpor was too high.

Click over to his full article to read about how states have been slow to report cases of mental illness to the National Instant Criminal Background Check System (NICS), but it’s also worth pointing out that the more important point point is whether the mental illness gets treated. The Treatment Advocacy Center reports that Arizona “is one of the worst states in the nation to be an individual with severe mental illness who needs help.” According to the organization, the state “jails or imprisons 9.3 times more people with severe mental illness than it hospitalizes,” “has 5.9 psychiatric beds per 100,000 population. (the recommended level to meet public need: 50 beds per 100,000,” and “is home to more than 50,000 people with schizophrenia, of whom a minimum of 25,000 are likely to be untreated at any given time.” State budget cuts are further diagonalizing the system.

The situation is even worse for those who don’t have insurance coverage, can’t purchase affordable insurance in the individual market (sometimes because of a mental health condition), or don’t qualify for Medicaid coverage or other forms of state aid. Estimates show that one-fifth to one-third of the uninsured are people with mental and substance use disorders and health reform may help them obtain coverage. Some are undoubtedly receiving insurance through the temporary high-risk insurance pools, and by 2014, they’ll be able to enroll in insurance through the exchanges, where private companies will have to offer mental health and substance use disorder services as part of the essential package of benefits. The law also expands parity — a requirement that benefits for mental illnesses to be on par with benefits for medical illnesses — “to a much wider pool, making it possible for millions more people to get the same coverage for substance abuse and illnesses like bipolar disorder, major depression and schizophrenia as they would for, say, diabetes or cancer.” Reform could also prove a vital tool in fighting the onset of mental illnesses in children and adolescents by defining “prevention broadly and make our focus on prevention a holistic one that includes promoting both physical and behavioral health.”

Experts estimate that four million Americans “have severe psychiatric disorders with a subset of 400,000 homeless and untreated not complying with their needed medications and another sub-sub set of 40,000 considered the most dangerous, not being treated or taking meds and demonstrating very violent behavior.” Of course it’s still unclear if Loughner would have benefited from mental treatment or care could have prevented Saturday’s tragedy. But as Jonathan Cohn points out, “After a major disaster, like an airliner crash or terrorist incident, we conduct thorough investigations to determine what caused the tragedy and how we might avoid another one like it. This occasion calls for a similar response. We may never know whether a better mental health care system would have averted this massacre. But we can be sure that it would avert some future ones.“

Following Saturday’s tragedy in Tucson, Arizona, which led to the death of six people and the serious injury of 20 others, including Rep. Gabrielle Giffords (D-AZ), Rep. Chellie Pingree (D-ME) echoed the growing call for a more civil political discourse by challenging Republicans to change the name of their health care repeal legislation. “The bill, titled the ‘Repeal the Job Killing Health Care Law Act,’ was set to come up for a vote this week, but in the wake of Gabby’s shooting, it has been postponed at least until next week,” she wrote in a blog post on the Huffington Post :

Don’t get me wrong — I’m not suggesting that the name of that one piece of legislation somehow led to the horror of this weekend — but is it really necessary to put the word “killing” in the title of a major piece of legislation? I don’t think that word is in there by accident — my Republican friends know as well as anyone the power of words to send a message. But in this environment and at this moment in our nation’s history, it’s not the message we should be sending.

The GOP has relied on the phrase “job killing” to frame the repeal effort as an economic endeavor that will help create American jobs and sustain the economy, but conservatives probably didn’t give much thought to the implications of the word “killing,” having relied on the rhetoric of ‘life and death’ so frequently throughout the health care reform debate. In fact, if it wasn’t for Saturday’s shooting, few people would have seriously considered the real meaning of the GOP’s words. In the aftermath of “death panels,” suggestions that the law may “cost you your life“, kill more people, and abort babies, the Republicans have downright numbed us all to their frequent use of death imagery as a tool to ferment political opposition. A quick look through the past 18 months or so reveals a stunning array of messages warning Americans that the Democrats’ signature legislation would lead to death.

Speaking at the Center for American Progress on the 15th anniversary of the Oklahoma City bombing which killed 168 people, including 19 children under the age of six, former President Bill Clinton drew parallels between that incident and the current atmosphere of right-wing, anti-government hatred. He specifically pointed to the influence of right-wing media in the 90s, saying that those hate radio hosts “understood clearly that emotion was more powerful than reason most of the time, and it happened that they got much bigger listenership, and more advertisers, and more commercial success, if they kept people in the white heat.” People like Timothy McVeigh were “highly vulnerable to the suggestions and implications of the most militant rhetoric of the time.” “We can’t let the debate veer so far into hatred that we lose focus of our common humanity,” he said. “We can’t ever fudge the fact that there’s a basic line dividing criticism from violence or its advocacy, and that the closer you get to the line and the more responsibility you have, you have to think about the echo chamber in which your words resonate”:

Oklahoma City proved that beyond the law, there is no freedom, and there is a difference between criticizing a policy or a politician, and demonizing the government that guarantees our freedoms and the public servants who implement them. And the more prominence you have in politics or media or some other pillar of public life, the more you have to keep that in mind. I acknowledged that in my political career, I had more on than one occasion, in the face of a government policy I disagreed with or a practice that I thought was insensitive, referred in a disparaging way generally to “federal bureaucrats,” as if all of them were arrogant or insensitive or unresponsive, and I have never done it again. You could not read the stories of the lives of the people who perished in Oklahoma City and not respond in that way.

In 2009, then House Speaker Nancy Pelosi (D-CA) similarly condemned the GOP’s rhetoric saying, “I have concerns about some of the language that is being used. … I saw this myself in the late ’70s in San Francisco. This kind of rhetoric…was very frightening and it created a climate in which…violence took place. … I wish that we would all…curb our enthusiasm in some of the statements that are made, understanding that some of…the ears that it is falling are not as balanced as the person making the statement might assume.”

Republicans will have an opportunity to set a new tone with they take up the health care repeal measure next week, but it remains to be see if they’ll be willing to give up a rather effective massaging strategy in the interest of the public good.