February 22, 2022 | Updates

Public Option Watch: NPR: ‘The 1st public option health plan in the U.S. struggles to gain traction’ 

WASHINGTON – Across the country, some state politicians are looking to create unaffordable, new government-controlled health insurance systems like the public option. One state has attempted to implement a version of the public option – the first and only state to do so – and they are seeing firsthand that a public option, no matter how it is structured, is unaffordable and unpopular. 

In “The 1st public option health plan in the U.S. struggles to gain traction” by Markian Hawryluk for NPR: 

The Washington Public Option Costs More for Consumers: 

  • Writing about Washington State, NPR reports that the state’s public option proponents estimated “public option plans having premiums 5% to 10% lower than traditional plans on the exchange. But public option premiums were, on average, 11% higher than the lowest silver plan premium available in each county on the marketplace in 2021, and a silver public option plan had the lowest premium in just nine counties. Silver plans cover, on average, about 70% of health care costs.” (NPR, 2/21/2022
  • Washington state lawmakers had to approve additional state funds to lower the cost of the public option. NPR also reported, “Washington legislators approved other moves to make the public option more affordable. They set aside $50 million in state subsidies, but officials must still determine how to allocate those funds.” (NPR, 2/21/2022
  • “Aditi Sen, a health economist with the Johns Hopkins Bloomberg School of Public Health[:] ‘You are trying to lower premiums enough that people will enroll but not so much that providers won’t participate.’ That will be a challenge for any state or federal public option plan. There are only so many ways to lower premiums. Hospitals, doctors and other health care professionals have pushed back hard against any cuts in their payment rates, while insurance plans balk at plans that could eat into their profits. Plans can reduce the size of their provider network to save money, but consumers dislike plans that limit which doctor they can see.” (NPR, 2/21/2022

The Public Option is Not Popular: 

  • In Washington State, “[o]nly 1% of people buying plans on the exchange chose public option plans in 2021.” (NPR, 2/21/2022
  • The latest edition of Voter Vitals, a nationwide tracking survey, found that 65 percent of voters prefer building the current system rather than creating the public option or opening up Medicare to younger Americans. (Voter Vitals, 12/6/21

These statistics out of Washington State come as California rejected a one-size-fits-all, single-payer health insurance system earlier this month due to its high cost and lack of support. 

Data continues to show that building on what’s working in health care is the most efficient way to ensure Americans have access to the affordable, high-quality health coverage and care they deserve. Rather than starting over by creating unaffordable, new government-controlled health insurance systems, lawmakers should focus on building on and improving what’s working in health care.   



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