Explaining the Public Option

Via Ezra Klein, Vanity Fair had the good idea to ask “could you confidently explain what exactly the public option is to someone who didn’t know?” The answer is no:


The public’s level of knowledge of policy issues is generally low, but as Ezra says it’s sobering to recall that the public option has gotten much more attention than other important aspects of the debate (the exchange, the minimum benefits package, subsidy schemes, employer mandate) of which public knowledge is almost certainly lower.

This is also, however, a somewhat damning indictment of the press. The fact of the matter is that while a lot has been written about political controversy about the public option relatively little has been written about what the public option actually is. But to make a long story short, the bills would create health insurance exchanges that would facilitate the purchase of health insurance on an individual market for people who don’t get insurance through their employers or Medicare or Medicaid. Part of how this works is that everyone who doesn’t get insurance through their employers or Medicare or Medicaid is going to be required to sign up for an exchange plan. Families will also be given subsidies to help them afford insurance. Presumably this large pool of potential customers is going to make insurance companies want to offer plans that meet the criteria for inclusion on the exchange. The “public option” proposal is the idea that in addition to whatever private industry wants to offer, the government ought to create a plan that consumers on the exchange can sign up for. As currently constituted, the public option doesn’t get any extra money from taxpayers beyond the premiums it takes in, and has no special links with Medicare, Medicaid, the VA health care system, or any other existing public sector program.