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Sahil Kapur Headshot

The Public Option "Opt-Out" Compromise Is Reasonable

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A new compromise has been floated for the public health insurance option: it's not co-ops, it's not a trigger; it's a provision that allows defiant states to opt out of offering the program to consumers. This idea has its problems (namely the millions who will be excluded) but as far as public plan compromises go, it's the best one anyone has come up with.

Most of America should have the option of a plan it has strongly and consistently supported throughout this dramatic debate. Blue states like California and New York will undoubtedly go for it, and millions will see an immediate improvement in their lives. Red states like Utah and Wyoming will probably strike it down. Either way, allowing states to offer a public plan seems like the bare minimum that should result from this legislation.

After all, this isn't simply a government entitlement or a handout to the poor; it's a "self-sustaining, independent, self-financed entity," as Senator Robert Menendez called it, designed primarily to meet people's health care needs, rather than make a profit. Thus the argument that it'll drive up the debt is irrelevant to what's actually being discussed.

So let it happen. Let Red America whine about big government while Blue America gets quality health care people can afford. Let conservatives rant about socialism, communism, fascism and Nazism while more of them die and go bankrupt due to a lack of health insurance. Let them turn to Rush Limbaugh and Glenn Beck, who will likely blame gays, immigrants, and European socialists while more lose their jobs as businesses migrate to blue states, where they can afford health care for their employees.

Let Michael Steele, John Boehner and Mitch McConnell (or whoever the GOP leaders are in 2016) explain to their constituents why their insurance premiums have doubled while blue-staters are relatively unburdened of their health care woes after embracing Socialized Medicine.

If the GOP really believed its rhetoric about how awful and Socialistic the public plan (or nearly any other government program) is, the smart response would be to welcome the opt-out compromise, trusting that its failure over time will prove their point. But my prediction is that won't happen, because the smarter Republicans know their cynical antics are about political posturing -- just as when they defamed Medicare the same way.

That's why Republican lawmakers will still fight this compromise tooth and nail, as they would any kind of a public option for anyone, because they fear having to justify the eventual discrepancies to their base. But considering how close the Finance Committee vote on Schumer's amendment was, 13-10, this concession could pick up the crucial few flips necessary to turn the tables.

Of course, this isn't as good as offering a strong Medicare-like insurance option opposite private plans to everyone in America. But the advantage of the opt-out provision is not merely that it's more politically feasible; it would also offer a real-life juxtaposition of an America with a public option and an America without one.

The impacts of the compromised provision would offer a revelatory perspective, divulging the Republican Party's propaganda and lies, such as they've been. It would strip their ability to later vilify the public option as the source of all the nation's ensuing problems, as Exhibit B would reveal how much worse things are without the program.

Despite the far-reaching horrors of the failed health care system, Republicans (and some conservative Democrats) continue to treat the issue as a petty, point-scoring political game. Not only will the opt-out compromise expose today's conservative movement for the vacuous farce it has become, it'll serve as a critical step to helping America understand public health insurance for what it really is. The states that waver today will come around tomorrow after seeing the results, and it'll soon be a dead issue.

And years from now, during the next health care debate, some tea-bagger will barge into a town hall and yell at his Congressman to "Keep your government hands off my public option!"