Inspired no doubt by her avid New Republic reading, Clinton has updated her health care issue page to emphasize support for creating public insurance options to compete with private health plans in Obamacare marketplaces.
“Hillary will work with interested governors, using current flexibility under the Affordable Care Act, to empower states to establish a public option choice.”
This is apparently a reference to section 1332 of the ACA, which provides states flexibility to experiment with new models, provided they meet regulatory and coverage standards.
Without more detail, there isn’t a whole lot to add. This has the potential to be a very good idea for individual states. But it also appears to lack the qualities that made the concept such an effective mobilizing tool in 2009. The idea then was to include a federally powered plan in every state exchange. A robust public option would’ve reduced costs significantly, and may have even swallowed private insurance markets, putting the country on a predictable path to national health care, while avoiding the maximal disruption that legislating Medicare-for-all outright would create.
Creating a public option in California could be a great advent. But it wouldn’t do anything directly to reform insurance in Texas. The hope may be that a handful of states experiment successfully with public options, and create models other states will follow in the future. A positive development! But not the goal that made the public option such a force seven years ago.