State-by-State Opt-Out Clause for Health Care Public Option Floated

Sounds like an interesting plan to me:

Publicoption "Senate Democrats have begun discussions on a compromise approach to
health care reform that would establish a robust, national public
option for insurance coverage but give individual states the right to
opt out of the program. The proposal is envisioned as a means of getting the necessary
support from progressive members of the Democratic Caucus — who have
insisted that a government-run insurance option remain in the bill —
and conservative Democrats who are worried about what a public plan
would mean for insurers in their states…But instead of starting with no national public option and giving
state governments the right to develop their own, the newest compromise
approaches the issue from the opposite direction: beginning with a
national public option and giving state governments the right not to
have one. 'It is being discussed,' said one progressive strategist who has
been working on reform with both the White House and Congress. 'In the
end obviously, the goal and near-term exercise is to get to the
bargaining table and get to the conference committee between the Senate
and House with the strongest position [on the public plan] possible.'"


  1. says

    Interesting idea. The problem is, you’ll potentially have people moving to states with the public option just for the health care. What would the benefits be for any state opting out?

    The real scary proposition is one that was floated and (I think) shot down: allowing people to cross state lines for private health insurance. That will just allow insurers to park in the state with the least regulation and give people out of state crappy coverage.

  2. David says

    Better still would be to allow citizen’s a one-time, irreversible opt-out option – with whatever increased or decreased tax liability that goes with it.

    Make it very clear that the opt-out is irreversible no matter what.

    People can either be entirely on their own for health care, no matter how well or badly life goes for them,

    or work with everyone else to ensure that everyone has health care no matter how well or badly life goes for them.

  3. Gregoire says

    Perfect! Let the red states collapse under less healthy and poorer constituents over time. My apologies to friends in Texas, Missouri, etc. Once people see the benefits of public option IN ACTION, the populations of participating states will increase.

  4. says

    The benefit to citizens in the states that opt-out is that they won’t be “Marxist socialists” and will stop dragging the rest of us down.

  5. Rocky says

    They cant even spell the fucking name of our country right.A large number of AMERICANS really are stupid.It amazes me how people were dickin’ around when Bill Maher made that comment.When its obviously the truth.

  6. Rad says

    I think state – by – state is smart! Then let the morons who declare “NIMBY!” to health care face their constituents when the folks in the next state over are getting healthy.

    Great idea! Much like state – by – state marriage equality.

  7. pete says

    Sounds like the old slavery option. When are we going to learn that the elite of a state do not have the right to control the life options of the poor. This is a sick idea that will end up further dividing rich and poor, north and south. Do we really need to divide the nation further?

  8. says

    I don’t like this precedent. Are we going to start doing this with other laws that are passed? If so, we are losing the core of centralized government and may as well start splitting up and become individual states.

    Either do it or don’t, but I’m against this approach.

  9. anon says

    There’s no real way to force states to provide insurance plans to their citizens or force people to buy such plans. Better funding for the already available free clinics would be the sanest approach. The fact that such clinics were just defunded in CA indicates the mess we might get into going nationwide. You’d think they’d at least provide CA with funding for their clinics as a show of support for the idea of free health care, but they seem more interested in “insurance” rather than actual care.

  10. jimmyboyo says

    David R

    You better refuse your social security checks and medicare when retired then. EVERYBODY (even the rich since the cap on SS tax is your first $150,00 and no SS tax after tat amount) receives MORE from SS and medicare than they put in… is not paid by what you pay but what younger generations pay in.

    You better refuse any fire assistance, police assistance, etc. since 1 police cruiser costs $25,000+…….

    You must turn off your electricity since the majority of the electricity infrastructure in the USA was set up by the rural electrification program paid for by the gov and the majority of utilities are gov subsidized co-ops


    besides dude, you are already covering all of the uninsured visiting emergency rooms via high premiums….a cut in your premiums would be beneficial to you but hey….conservatives are not know for intelligence or self interest. More like brainwashed lemmings

    Medicare is opt out and AZ did opt out for about 2-3 yrs before political pressure forced the state to join

    4-5 states max would opt out and within a few years opt in. repubs who push the opt out would be driven from office


  11. Arthur says

    The state by state regulations is one of the major problems. This crap is beginning to sound like the bad health care system we already have, 2.0.

  12. mcc says

    JIMMYBOYO: I hadn’t heard that before, where could I find more information about the medicare opt-out you mention?

  13. stolidog says

    State by State option would be just fantastic. Red staters won’t get insured and blue staters would have to pay for their emergency care through taxes, just like now.

    I think blue staters need to start moving to red states for all the incredible tax benefits they receive from the blue states.

  14. jimmyboyo says


    i meant WAS opt out when set up

    Medicare is Not opt out anymore

    When medicare was set up it was opt out for states only (not individuals) AZ opted out for the first years but the population of AZ saw the benefits for the elderly in all of the other states and forced their state to opt in.

    Medicare is now officialy nationalized, sorry for the misunderstanding if you thought you could opt out of medicare as an individual

  15. says

    @ JIMMYBOYO: I think you mis-understood my comment. I put “Marxist Socialist” in scare quotes because the Right is using those terms to scare ignorant people. I am all for nationalized healthcare and other democratic socialist programs. Like you, I recognize such things as social security, police and fire protection, etc., as socialist.

  16. Z says

    The devil’s in the details of course, but a single federally run public plan that states can opt in or out of sounds like an awesome idea. I do wonder about who will be doing the “opting.” Will it get stuck in New York’s dysfunctional legislature? Will Schwarzenegger veto it in California? Many questions remain.