Tuesday, October 27, 2009

Opting In, Opting Out, Why The Next Election Is Vitally Important

As Cordelia Lear pointed out at Blogging for MI yesterday, the opt-out choice that allows states to withdraw from the public option is no panacea. Read what she says about Mike Bishop and Andy Dillon to understand why opt-out is a bad idea, but it's basically because the public option choice will literally be in the hands of lawmakers who don't care about us.

I originally figured I could live with the opt-out plan because it's loosely modeled on Medicaid, "which originally allowed states to “opt-out” of the program and today enjoys the participation of all 50 states." And, as TPM pointed out, there was good reason to believe that the public option would have been a lot scarier as a GOP straw man than it would as a real world option for people who can't get private coverage.
And if the public option is available in North Carolina, just to pick a hypothetical, and not South Carolina, after a while, people in the South Carolina might start to wonder what the logic was of denying them a lower cost health insurance option. And if that's true, presumably, pressure will build in the opt-out states to opt-in. So even if a substantial number of people aren't covered at the start, there's good reason to believe that will change over time.
There's just one tiny problem with the "presumably, pressure will build to opt-in" scenario. We're dealing with politicians who often put party ideology ahead of people. If pressuring our leaders worked, we would have had health care a long time ago.

And, as Cordelia mentioned, it's not exactly clear who gets to do the opting-out. Will governors be able to unilaterally make that decision or will it take action by both houses of the state legislature? As Jon Walker at FDL pointed out, depending on how the opt-out is written, millions of people in states controlled by Republicans could find themselves disenfranchised.

If a Republican becomes Michigan's next governor, or they manage to pick up any seats, we can kiss opting-in goodbye. Seriously. That makes the next election extremely important because there's just one thing standing between national health care and the 1.13 million uninsured adults in our state - Republicans (and DINO's like Dillon).

(Cross-posted at Blogging for MI.)


K. said...

I can't speak for Michigan, but an opt-out would be really tough to pass in Washington state. I'm not saying that because of the current Democratic majority, either. Once a public option was in, it would create a political earthquake to even try to get rid of it.

Johnny C said...

That's the one problem I have with the opt in or out clause I don't trust the republican governors like Pawlatey and Jindal who are only interested in getting support from that nutty 20% crowd if they choose to run in 2012. Other than that republicans would be hard press to explain to people why they can't get affordable health care like people in state A.

Kathy said...

K, you're fortunate to live in a state run by reasonable lawmakers who care about the welfare of their citizens. Our state is run by Republicans who only care about making Democrats look bad. "Just say no" is their creed to live by, unless it benefits businesses, and then it's yes, yes, yes all the time.

Johnny, I think Republicans will be hard pressed to explain opting out too, especially considering that a majority of people want the public option, but that won't prevent them from trying.

In Jindal's case, he huffed and puffed that he didn't want any stimulus funds, but he took them anyway and then tried to take credit for them. I suspect some Republicans will do the same thing with public health care. They're spout off their nonsense and then turn around and try to take credit for the plan.

Kvatch said...

...the opt-out choice that allows states to withdraw from the public option is no panacea.

"No panacea?" Quite the contrary, it is the death of the public option. No mandatory availability because of opt-out, no critical mass of individuals in the plan; no critical mass, no leverage; no leverage, no cost savings; no cost savings, eventually no public option. Donzo.

Johnny C said...

That's true kenneth the page would take credit if people in louisiana love having the public option. Hopefully the michigan dems would use this against the republicans next fall.

Kathy said...

Kvatch, I'm trying to be optimistic that a majority of states will choose to stay in the plan, however, I don't underestimate the will of the enemy - those Republicans and DINOs who care more about lobbyists and ideology than they do our health. As long as they remain in office, the public option is at risk.